Differential Diagnosis of Small Single Solid Thyroid Nodules using Real-Time Ultrasound Elastography

Wang, Yuchen; Hj, Dan; Hy, Dan; T, Li; Hu, Baishi

doi:10.1177/147323001003800210

Cited by 77 publications

(75 citation statements)

References 18 publications

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“…A long-term clinical study determined that the hardness of lesions differs between malignant and benign tissues, with increased hardness being associated with an increased risk of malignancy (25). Furthermore, a study conducted by Wang et al (26) identified that UE had high diagnostic sensitivity and specificity for nodules measuring <1 mm in diameter. Similarly, the sensitivity, specificity and accuracy of UE diagnosis of the 80 TMC cases in the present study (Fig.…”

Section: Discussionmentioning

confidence: 99%

Clinical value of elasticity imaging and contrast-enhanced ultrasound in the diagnosis of papillary thyroid microcarcinoma

Zhang

Wang

et al. 2015

Oncology Letters

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Abstract. The present study aimed to evaluate the value of elasticity imaging and contrast-enhanced ultrasonography (CEUS) in the differential diagnosis of papillary thyroid microcarcinoma (TMC). In total, 73 patients exhibiting a total of 80 small thyroid nodules, which were difficult to diagnose using conventional ultrasonography, underwent elasticity imaging and CEUS. The diagnostic findings were subsequently clarified by intraoperative and pathological examination, and the accuracy of the 2 diagnostic methods was compared. The correct diagnostic rate of CEUS was 85% (68/80 nodules), of which 6 cases of TMC were misdiagnosed as benign lesions and 6 benign nodules were misdiagnosed as TMC. By contrast, the accuracy rate of the elasticity imaging, based on the 5-point diagnostic method, was 92.5% (74/80 nodules), of which 3 cases of TMC were misdiagnosed as benign nodules and 3 benign nodules were misdiagnosed as TMC. Furthermore, elasticity imaging in the diagnosis of TMC was determined to have sensitivity, specificity and accuracy rates of 94.0, 90.0 and 92.5%, respectively, whereas the corresponding rates for CEUS were 88.0, 80.0 and 85.0%, respectively. Thus, ultrasonographic elasticity imaging exhibited significant advantages in the diagnosis of TMC compared with CEUS (P<0.05). The use of CEUS demonstrates no evident advantage in the diagnosis of TMC; however, an elasticity score of ≥3 is of high clinical value as a diagnostic criterion for TMC. IntroductionAt present, there are >300 million individuals with thyroid disease worldwide (1). In particular, thyroid nodules, which are the second most common endocrine system disease, have received increasing attention (2,3). Conventional ultrasonography was previously considered to be the preferred diagnostic tool for patients with thyroid disease, and has been reported as the most effective method for the clinical assessment and treatment of this disorder (4). However, with the development of high-frequency ultrasonography, the early detection of thyroid lesions has improved (5). Thus, high-frequency ultrasonography has become the preferred method for the clinical evaluation and treatment of thyroid disease (6). Accordingly, thyroid nodules identified on cervical ultrasonographic examination account for 50% of all reported thyroid nodules (7). Papillary thyroid microcarcinoma (TMC) is an early-stage subtype of thyroid carcinoma with a maximum tumor diameter of ≤10 mm and a frequency of 65-99% among all thyroid carcinomas (8). However, nodular thyroid lesions measuring ≤1 cm in diameter may possess features that are characteristic of different types of lesions, commonly resulting in an uncertain diagnosis during pre-operative conventional ultrasonography (8). Therefore, the development of novel pre-operative diagnostic methods is required.In previous years, contrast-enhanced ultrasound (CEUS) and ultrasonic elastography (UE) have become popular research topics, and these modalities have been proposed for the diagnosis and differential diagnosis of thyroid lesion...

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Section: Discussionmentioning

confidence: 99%

Clinical value of elasticity imaging and contrast-enhanced ultrasound in the diagnosis of papillary thyroid microcarcinoma

Zhang

Wang

et al. 2015

Oncology Letters

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“…Conventional US has a moderate accuracy for characterizing the nature of thyroid nodules, thus supplementary diagnostic methods, including radionuclide scanning and fine-needle aspiration (FNA) biopsy, are employed for improved clinical evaluation of thyroid nodules (12)(13)(14). With the introduction of contrast-enhanced ultrasound (CEUS) and real-time elastography (RTE), promising results have been reported for better accuracy in differentiating between benign and malignant thyroid nodules (15)(16)(17).…”

Section: Introductionmentioning

confidence: 99%

Contrast-enhanced ultrasound and real-time elastography in the differential diagnosis of malignant and benign thyroid nodules

Xin

Liu

Jia

et al. 2016

Experimental and Therapeutic Medicine

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Abstract. The diagnostic value of contrast-enhanced ultrasound (CEUS) or real-time elastography (RTE) alone, as well as a combination of CEUS and RTE, in distinguishing benign from malignant thyroid nodules was investigated. Between August 2012 and June 2014, a total of 97 consecutive patients (50 male and 47 female patients; mean age, 48.6±12.4; age range, 27-70 years) with thyroid nodules referred for surgical treatment were examined by CEUS and RTE. The final diagnosis was obtained based on histological findings. Image analysis of the CEUS and RTE scans was performed. Considering the postoperative pathological results as the golden standard, a receiver operating characteristic (ROC) curve was constructed. Subsequently, the sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and accuracy of CEUS alone, RTE alone and CEUS + RTE combination were calculated. Pathological examination showed 66 papillary carcinomas and 43 benign lesions, including 21 adenomas and 22 nodular goiters. The sensitivity, specificity, PPV, NPV and accuracy of CEUS were 81.82, 90.70, 93.10, 90.70 and 85.32%, respectively. In the case of RTE, the sensitivity, specificity, PPV, NPV and accuracy were 80.30, 88.37, 91.38, 88.37 and 83.49%, respectively. Furthermore, the combination of CEUS + RTE had a sensitivity of 95.45%, specificity of 95.35%, PPV of 96.92%, NPV of 95.35% and accuracy of 95.41%. Therefore, the CEUS + RTE combination showed a significantly higher sensitivity and specificity compared with CEUS or RTE alone (all P<0.05). Based on ROC analysis, the area under the curve (AUC) for CEUS, RTE and CEUS + RTE combination was 0.883, 0.863 and 0.959, respectively. The AUC of RTE alone was significantly lower compared with that of the CEUS + RTE combination. In conclusion, our results demonstrate that CEUS + RTE combination significantly increases the diagnostic performance for differential diagnosis of malignant and benign thyroid nodules compared with CEUS or RTE alone.

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“…Konu ile ilgili birçok çalışmada mikrokalsifikasyonun tiroid kanseri ile yakın ilişkili olduğu bildirilmektedir (26)(27)(28)(29)(30) . Mikrokalsifikasyonlar, nodül içerisinde USG'de hiperekojen odaklar şeklinde görülmekte olup, genellikle çok sayıdadırlar ve boyutları 2 mm'den kü-çüktür (31) .…”

Section: Discussionunclassified

“…Nodül vaskülaritesi ile ilgili yapılan birtakım araş-tırmalarda, çeşitli skorlamalar kullanılmakla birlikte çalışmaların büyük kesiminde, vaskülarite ile malignite arasında belirgin bir ilişki gösterilememiştir (27)(28)(29)(30) . Ancak nodül içi vaskülarite ile malignite arasında anlamlı ilişki olduğunu ortaya koyan çalışma-lar da literatürde bulunmaktadır (31,32) .…”

Section: Discussionunclassified

Determination of increased suspectibility to malignancy in thyroid nodules bu ultrasonograpic findings, with the written reports and pathology results

Özer¹,

Özel²,

Özel³

et al. 2016

Okmeydani Medical Journal

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Differential Diagnosis of Small Single Solid Thyroid Nodules using Real-Time Ultrasound Elastography

Cited by 77 publications

References 18 publications

Clinical value of elasticity imaging and contrast-enhanced ultrasound in the diagnosis of papillary thyroid microcarcinoma

Clinical value of elasticity imaging and contrast-enhanced ultrasound in the diagnosis of papillary thyroid microcarcinoma

Contrast-enhanced ultrasound and real-time elastography in the differential diagnosis of malignant and benign thyroid nodules

Determination of increased suspectibility to malignancy in thyroid nodules bu ultrasonograpic findings, with the written reports and pathology results

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