J Korean Soc Radiol.  2012 Dec;67(6):417-423. 10.3348/jksr.2012.67.6.417.

Diagnostic Accuracy of Detecting Hashimoto's Thyroiditis in Thyroid Cancer Patients Who Underwent Thyroid Surgery: Comparison of Ultrasonography, Positron Emission Tomography/CT, Contrast Enhanced CT, and Anti-Thyroid Antibody

• Kim YG
• Lee TH
• Park DH
• Nam S

• KMID: 2097976
• DOI: http://doi.org/10.3348/jksr.2012.67.6.417

Abstract

PURPOSE
To compare the diagnostic accuracy of ultrasonography (US), F18-fluorodeoxyglucose positron emission tomography/CT (PET/CT), contrast enhanced CT (CECT), serum anti-thyroid antibody for detecting Hashimoto's thyroiditis in thyroid cancer patients who underwent neck surgery.
MATERIALS AND METHODS
A total of 150 patients with suspicious for thyroid cancer, who had previously undergone US guided needle aspiration of thyroid, were evaluated with the use of US, PET/CT, CECT and serum anti-thyroid antibody. The four studies were performed within two months before neck surgery. Hashimoto's thyroiditis was confirmed by histopathological results. The diagnostic accuracy of US, PET/CT, CECT and serum anti-thyroid antibody were calculated statistically.
RESULTS
Hashimoto's thyroiditis was diagnosed in 51 out of the 150 patients, following neck surgery. The sensitivity, specificity, positive predictive value, negative predictive value and accuracy of US were 76.5%, 92.9%, 84.8%, 88.5%, and 87.3%, respectively. The corresponding values of PET/CT were 37.3%, 96.0%, 82.6%, 74.8%, and 76.0%, and CECT were 62.7%, 89.9%, 76.2%, 82.4%, and 80.7%, and serum anti-thyroid antibody level were 90.2%, 93.9%, 88.5%, 94.9%, and 92.7%, respectively. McNemar test revealed significant difference among PET/CT and others, but no significant differences among US, CECT and serum anti-thyroid antibody. Overall, serum anti-thyroid antibody showed most accurate diagnostic performance.
CONCLUSION
In detecting Hashimoto's thyroiditis, serum anti-thyroid antibody showed higher diagnostic accuracy than others. US also showed relatively high diagnostic accuracy.

MeSH Terms

Electrons
Humans
Neck
Needles
Positron-Emission Tomography
Sensitivity and Specificity
Thyroid Gland
Thyroid Neoplasms
Thyroiditis

Figure

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  Fig. 1 Ultrasonography (US) of 22-year-old woman who diagnosed as Hashimoto's thyroiditis. A, B. Axial (A) and longitudinal (B) US images show marked decreased size of left thyroid gland (arrows) (AP diameter = 7 mm, longitudinal diameter = 27 mm).

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  Fig. 2 Ultrasonography (US) of 56-year-old woman who diagnosed as Hashimoto's thyroiditis. US shows heterogeneous decreased echogenicity (arrows) and innumerable micronodules (arrowheads) scattered in right thyroid gland.

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  Fig. 3 Ultrasonography (US) of 61-year-old woman who diagnosed as Hashimoto's thyroiditis. US shows linear hyperechoic septa (arrows) and focal decreased echogenecity of right thyroid gland (arrowheads).

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  Fig. 4 Ultrasonography (US) of 39-year-old woman who diagnosed as Hashimoto's thyroiditis. US shows enlarged lymph nodes (arrows) at both infrathyroidal paratracheal areas.

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  Fig. 5 CECT and PET/CT of 60-year-old woman who diagnosed as Hashimoto's thyroiditis. A. PET/CT image shows diffuse FDG uptake (SUVmax = 2.9) of thyroid gland. B, C. Axial and coronal contrast enhanced CT images show increased size (AP diameter = 35 mm), decreased enhancement (HU = 136) of thyroid gland and enlarged lymph nodes (arrows) at both infrathyroidal paratracheal areas. Note.-CECT = contrast enhanced CT, FDG = F18-fluorodeoxyglucose, HU = Hounsfield units, PET/CT = positron emission tomography/CT, SUV = standardized uptake value

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