The evolving role of MRI in the detection of extrathyroidal extension of papillary thyroid carcinoma: a systematic review and meta-analysis

Abstract Background Papillary thyroid carcinoma (PTC) is the predominant form of thyroid cancer, and the presence of extrathyroidal extension (ETE) significantly impacts treatment decisions and prognosis. Accurate preoperative detection of ETE remains challenging, highlighting the need to evaluate a...

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Main Authors: Mona Javid, Arian Mirdamadi, Mohammadreza Javid, Mohammad-Hossein Keivanlou, Ehsan Amini-Salehi, Naeim Norouzi, Elahe Abbaspour, Ahmad Alizadeh, Farahnaz Joukar, Fariborz Mansour-Ghanaei, Soheil Hassanipour
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Language:English
Published: BMC 2024-12-01
Series:BMC Cancer
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Online Access:https://doi.org/10.1186/s12885-024-13288-1
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author Mona Javid
Arian Mirdamadi
Mohammadreza Javid
Mohammad-Hossein Keivanlou
Ehsan Amini-Salehi
Naeim Norouzi
Elahe Abbaspour
Ahmad Alizadeh
Farahnaz Joukar
Fariborz Mansour-Ghanaei
Soheil Hassanipour
author_facet Mona Javid
Arian Mirdamadi
Mohammadreza Javid
Mohammad-Hossein Keivanlou
Ehsan Amini-Salehi
Naeim Norouzi
Elahe Abbaspour
Ahmad Alizadeh
Farahnaz Joukar
Fariborz Mansour-Ghanaei
Soheil Hassanipour
author_sort Mona Javid
collection DOAJ
description Abstract Background Papillary thyroid carcinoma (PTC) is the predominant form of thyroid cancer, and the presence of extrathyroidal extension (ETE) significantly impacts treatment decisions and prognosis. Accurate preoperative detection of ETE remains challenging, highlighting the need to evaluate advanced imaging techniques.This systematic review and meta-analysis aimed to investigate the diagnostic accuracy of magnetic resonance imaging (MRI) in detecting extrathyroidal extension (ETE) among patients diagnosed with papillary thyroid carcinoma (PTC). Method We conducted a comprehensive search of global databases including PubMed, Web of Science, EMBASE, and the Cochrane Library, spanning from inception to November 03, 2024. We included studies that utilized preoperative MRI to evaluate the presence of ETE. Quality assessment was carried out using the Joanna Briggs Institute (JBI) standard checklists. Data analysis was performed using Comprehensive Meta-Analysis (CMA) software version 3. The study protocol was registered in PROSPERO (CRD42024499536). Result Six studies were included in our final quantitative analysis. The included studies were classified into two groups; the first group focused on evaluating the accuracy of MRI in detecting ETE, while the second group assessed the apparent diffusion coefficient (ADC). The accuracy of MRI for overall ETE, minimal ETE (mETE), and gross ETE (gETE) was 81.0% (95% CI: 76.9%-85.6%), 72.9% (95% CI: 66.2%-78.6%), and 83.3% (95% CI: 75.2%-89.1%), respectively. MRI demonstrated a statistically significant difference in detecting gETE compared to mETE (OR = 1.85, 95% CI: 1.01–3.37, P-value = 0.045). Our analysis showed that the ADC of the lesion for b-value 500 is lower in patients with ETE compared to those without ETE (SMD = 0.95, 95% CI: 0.28–1.62, P-value = 0.005). Conclusion Our findings demonstrate that MRI has substantial accuracy in detecting ETE in PTC, especially for gross ETE. This suggests MRI could be a valuable tool in preoperative planning, helping to guide surgical decision-making by more precisely identifying patients at higher risk. However, the limited number of studies underscores the need for further research to confirm MRI’s role in routine clinical practice and to refine imaging protocols for more accurate differentiation between minimal and gross ETE.
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series BMC Cancer
spelling doaj-art-bdf2b36ffe364448b3487a2f4c7fbf9f2024-12-22T12:31:08ZengBMCBMC Cancer1471-24072024-12-0124111310.1186/s12885-024-13288-1The evolving role of MRI in the detection of extrathyroidal extension of papillary thyroid carcinoma: a systematic review and meta-analysisMona Javid0Arian Mirdamadi1Mohammadreza Javid2Mohammad-Hossein Keivanlou3Ehsan Amini-Salehi4Naeim Norouzi5Elahe Abbaspour6Ahmad Alizadeh7Farahnaz Joukar8Fariborz Mansour-Ghanaei9Soheil Hassanipour10Gastrointestinal and Liver Diseases Research Center, Guilan University of Medical SciencesGastrointestinal and Liver Diseases Research Center, Guilan University of Medical SciencesGastrointestinal and Liver Diseases Research Center, Guilan University of Medical SciencesStudent Research Committee, School of Medicine, Guilan University of Medical SciencesGastrointestinal and Liver Diseases Research Center, Guilan University of Medical SciencesStudent Research Committee, School of Medicine, Guilan University of Medical SciencesGastrointestinal and Liver Diseases Research Center, Guilan University of Medical SciencesDepartment of Radiology, School of Medicine, Poursina Hospital, Guilan University of Medical SciencesGastrointestinal and Liver Diseases Research Center, Guilan University of Medical SciencesGastrointestinal and Liver Diseases Research Center, Guilan University of Medical SciencesGastrointestinal and Liver Diseases Research Center, Guilan University of Medical SciencesAbstract Background Papillary thyroid carcinoma (PTC) is the predominant form of thyroid cancer, and the presence of extrathyroidal extension (ETE) significantly impacts treatment decisions and prognosis. Accurate preoperative detection of ETE remains challenging, highlighting the need to evaluate advanced imaging techniques.This systematic review and meta-analysis aimed to investigate the diagnostic accuracy of magnetic resonance imaging (MRI) in detecting extrathyroidal extension (ETE) among patients diagnosed with papillary thyroid carcinoma (PTC). Method We conducted a comprehensive search of global databases including PubMed, Web of Science, EMBASE, and the Cochrane Library, spanning from inception to November 03, 2024. We included studies that utilized preoperative MRI to evaluate the presence of ETE. Quality assessment was carried out using the Joanna Briggs Institute (JBI) standard checklists. Data analysis was performed using Comprehensive Meta-Analysis (CMA) software version 3. The study protocol was registered in PROSPERO (CRD42024499536). Result Six studies were included in our final quantitative analysis. The included studies were classified into two groups; the first group focused on evaluating the accuracy of MRI in detecting ETE, while the second group assessed the apparent diffusion coefficient (ADC). The accuracy of MRI for overall ETE, minimal ETE (mETE), and gross ETE (gETE) was 81.0% (95% CI: 76.9%-85.6%), 72.9% (95% CI: 66.2%-78.6%), and 83.3% (95% CI: 75.2%-89.1%), respectively. MRI demonstrated a statistically significant difference in detecting gETE compared to mETE (OR = 1.85, 95% CI: 1.01–3.37, P-value = 0.045). Our analysis showed that the ADC of the lesion for b-value 500 is lower in patients with ETE compared to those without ETE (SMD = 0.95, 95% CI: 0.28–1.62, P-value = 0.005). Conclusion Our findings demonstrate that MRI has substantial accuracy in detecting ETE in PTC, especially for gross ETE. This suggests MRI could be a valuable tool in preoperative planning, helping to guide surgical decision-making by more precisely identifying patients at higher risk. However, the limited number of studies underscores the need for further research to confirm MRI’s role in routine clinical practice and to refine imaging protocols for more accurate differentiation between minimal and gross ETE.https://doi.org/10.1186/s12885-024-13288-1AccuracyApparent diffusion coefficientExtrathyroidal extensionMagnetic resonance imagingMeta-analysisSystematic review
spellingShingle Mona Javid
Arian Mirdamadi
Mohammadreza Javid
Mohammad-Hossein Keivanlou
Ehsan Amini-Salehi
Naeim Norouzi
Elahe Abbaspour
Ahmad Alizadeh
Farahnaz Joukar
Fariborz Mansour-Ghanaei
Soheil Hassanipour
The evolving role of MRI in the detection of extrathyroidal extension of papillary thyroid carcinoma: a systematic review and meta-analysis
BMC Cancer
Accuracy
Apparent diffusion coefficient
Extrathyroidal extension
Magnetic resonance imaging
Meta-analysis
Systematic review
title The evolving role of MRI in the detection of extrathyroidal extension of papillary thyroid carcinoma: a systematic review and meta-analysis
title_full The evolving role of MRI in the detection of extrathyroidal extension of papillary thyroid carcinoma: a systematic review and meta-analysis
title_fullStr The evolving role of MRI in the detection of extrathyroidal extension of papillary thyroid carcinoma: a systematic review and meta-analysis
title_full_unstemmed The evolving role of MRI in the detection of extrathyroidal extension of papillary thyroid carcinoma: a systematic review and meta-analysis
title_short The evolving role of MRI in the detection of extrathyroidal extension of papillary thyroid carcinoma: a systematic review and meta-analysis
title_sort evolving role of mri in the detection of extrathyroidal extension of papillary thyroid carcinoma a systematic review and meta analysis
topic Accuracy
Apparent diffusion coefficient
Extrathyroidal extension
Magnetic resonance imaging
Meta-analysis
Systematic review
url https://doi.org/10.1186/s12885-024-13288-1
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