Preoperative ultrasound characteristics of metastatic papillary thyroid carcinoma (PTC) that are significantly associated with pathologically determined extranodal extension (ENE) have been identified, according to a study published in JAMA Otolaryngology – Head & Neck Surgery.1

Researchers led by Jesse Qualliotine, BS, of The Johns Hopkins University School of Medicine in Baltimore, MD, conducted a single-institutional, retrospective analysis of 29 patients with metastatic PTC from December 2007 to May 2012.

They extracted clinicodemographic and histopathologic data, and scored preoperative ultrasound images for characteristics of interest through radiology and pathology reports.

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With a median age at diagnosis of 47 years, there were no significant differences in distributions of clinicodemographic or histopathologic characteristics between those with ENE (11 patients) compared with those without ENE.

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The researchers found that the following characteristics were significantly associated with ENE positivity: node matting, presence of node matting or cystic areas, composite score of 3 or more ultrasound characteristics, as well as presence of node matting, perinodal edema, or unclear margins.

Additionally, a composite score of 3 or more ultrasound characteristics had the highest accuracy for predicting ENE positivity.


  1. Qualliotine JR, Coquia SF, Hamper UM, et al. Association of ultrasound characteristics with extranodal extension in metastatic papillary thyroid carcinoma [published online ahead of print February 4, 2016]. JAMA Otolaryngol Head Neck Surg. doi: 10.1001/jamaoto.2015.3558.