Efficiency of Ultrasound Screening in Papillary Thyroid Cancer Patients with Excellent Response to Therapy

Abstract

Objectives:

To investigate the efficiency of ultrasound surveillance in detecting recurrences of papillary thyroid cancer (PTC) in patients with an excellent response (ER) to therapy.

Methods:

In a single center, patients diagnosed with PTC between 2000 and 2018 were evaluated, and data from 477 patients followed up with ultrasonography (USG) were included in the analysis. The study cohort was divided into excellent response (ER) and non-excellent response (non-ER) groups. Follow-up ultrasound scans' positive predictive value (PPV) and negative predictive value (NPV) were calculated.

Results:

The median surveillance time was 76 (36–240) months. Nine recurrences were observed. The recurrence rate was 0.3% in the ER group. The maximum time until recurrence after the initial one-year assessment was 1 year in the ER group, while it extended to 2 years in the non-ER group. Among the 11 patients who underwent fine needle aspiration cytology (FNAC) due to atypical findings in the ER group, one was found to have metastasis (9%). The combined PPV of USG in the ER group was only 1.78%. Since no recurrence was detected in the ER group in later years, the only assessable annual PPV was in the second year after diagnosis. The ER group exhibited an annual PPV of 7.69% and an NPV of 100%. In contrast, the non-ER group had annual PPV and NPV rates of 34.78% and 95.65%, respectively.

Conclusion:

Patients with an ER in the first year of treatment can be followed up with clinical examination and serum unstimulated thyroglobulin alone starting three years after diagnosis.

Keywords

ultrasonography - treatment outcome - ultrasound screening - papillary thyroid cancer - dynamic risk stratification - lymph node metastasis

Publication History

Received: 27 December 2024

Accepted after revision: 12 June 2025

Article published online:
30 July 2025

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