Skip to main content

Table 4 Representative literature on sonographic prediction of thyroid cancer prognosis

From: Indolent thyroid cancer: knowns and unknowns

Author Year Number of cases and histologic subtype Size range Prognostic measure Sonographic parameters studied Selected results
Cappelli et al. [53] 2007 484 PTC <1.0 cm to > 4.0 cm Recurrence of disease or death due to thyroidcancer Blurred margins, presence of calcifications, intranodular vascularity, hypoechogenicity, multifocality, extracapsular growth Among investigated sonographic parameters, only intranodular flow associated with unfavorable outcome
Du et al. [34] 2015 177 PTC
3 follicular
6 medullary
N/A LN mets Size, peak systolic velocity, pulsatility index, resistive index, multifocality, bilateral vs. unilateral, nodule border, edge irregularity, halo, solid/cystic vs. solid, uniformity of echogenicity, echogenicity, microcalcifications, flow grade, capsular invasion Large size, percent contact with thyroid capsule, microcalcifications, flow grade 3–4 (graded from 0–4), resistive index >0.654, peak systolic velocity > 24.5 cm/s associated with LN mets.
Additional categories not associated with LN mets.
Fukuoka et al. [35] 2015 480 PTC in 384 patients <1.0 cm Increase in tumor size ≥3 mm (prospective trial) Calcification pattern, tumor vascularity Macroscopic/rim calcifications and poor vascularity on most recent follow-up associated with non-progression of disease. These features were also strongly associated with advanced age.
Gweon et al. [54] 2016 397 PTC 3–35 mm ETE
LN mets
Tumor composition, echogenicity, margins, calcifications, shape, TI-RADS category (Kwon classification), size Size associated with ETE.
Size, microcalcifications associated with LN mets.
All additional categories not associated with ETE or LN mets
Kamaya et al. [33] 2015 62 PTC >1.0 cm ETE Capsular abutment, contour bulging, vascularity beyond capsule, loss of echogenic capsule Capsular abutment 100% sensitive for extracapsular extension
Loss of echogenic capsule was best predictor of ETE.
Kim et al. [30] 2011 354 PTC ≤2 cm ETE
LN mets
Size, shape, margin, echogenicity, calcification, vascularity, contact with capsule Size >0.5 cm, marked hypoechogenicity, contact with capsule associated with ETE.
Marked hypoechogenicity associated with LN mets.
Additional factors were not predictive.
Lai et al. [55] 2016 367 PTC ≤1.0 cm ETE
LN mets
Size, shape, length/width ratio, border, peripheral halo, echogenicity, cystic change, calcification (any), vascularity, presence of Hashimoto’s thyroiditis Size associated with LN mets and ETE.
Calcification (any), multifocality associated with LN mets only for microcarcinoma > 5 mm.
Additional features were not associated with LN mets; no US features associated with LN mets for microcarcinoma < 5 mm.
Lee et al. [31] 2014 568 PTC 3–49 mm ETE Size, lesion location, echogenicity, (LN stage), % abutment of thyroid capsule, capsular protrusion Size, thyroid capsular protrusion, % abutment of thyroid capsule are all associated with ETE.
Zhan et al. [32] 2012 155 PTC <10 mm to greater than 40 mm LN mets Size, shape, border, margin, halo, internal architecture, echogenicity, homogeneity of echotexture, calcification, contact between nodule border and thyroid, vascularity, peak systolic velocity, pulsatility index, resistive index Size, contact percentage, combined microcalcifications/ macrocalcifications, increased vascularity, high resistive index difference associated with LN mets.
No association seen with other parameters.
  1. PTC papillary thyroid carcinoma, ETE extrathyroidal extension, LN mets, LYMPH node metastases