Gray-scale three-dimensional sonography of thyroid nodules: feasibility of the method and preliminary studies

Abstract

The aim of the study was differential evaluation of new and classical sonographic features of benign thyroid nodules and thyroid cancer with three-dimensional gray-scale sonography and evaluation of the effectiveness of the thin-slice surface rendered images in comparison with multiplanar reformation (MPR) presentation. Fifty-four thyroid nodules were interactively evaluated with thin-slice smooth surface rendering: shape in the c-plane (parallel to the probe) and evaluation of echogenicity, margins and calcification/microcalcification-like echogenic foci in the a-plane (plane of the probe). Evaluation of the level of agreement in readers' interpretation and between sonographic techniques was performed using the kappa statistic. Surface rendering permitted visualization of the shape of the nodule in the c-plane in all cases, in contrast to only up to 48% of cases in MPR evaluation. Lobulated nodule shape in the c-plane was 82-100% sensitive and 47-53% specific in diagnosis of carcinoma. Surface rendered images showed more calcification/microcalcification-like echogenic foci than MPR ones. The level of agreement between the observers in the evaluation of features of thyroid nodules and the agreement between features of thyroid nodules on MPR and surface-rendered images showed at least moderate reproducibility (kappa>or=0.41). Three-dimensional thin-slice surface rendering sonography appears to be a feasible and effective method for thyroid nodule evaluation.

Localization and Amount of Thyroid Remnant in Totally Thyroidectomized

“…In this study, US was shown to be a sensitive method for the detection of recurrent or persistent thyroid disease in patients with total thyroidectomies and it can be used safely as an effective monitoring tool in patients with even minimal thyroid remnant. One study reported that either 2D or 3D US images are effective and sensitive methods for the evaluation of thyroid nodules (7). However, in our study, thyroid scintigraphy and uptake measurement were more sensitive diagnostic tests than US for the detection of thyroid remnant, especially for minimal thyroid remnant in the thyroid bed that is clinically negligible.…”

Observer variability in the sonographic evaluation of thyroid nodules

“…[21][22][23][24] However, there are few studies of observer variability in thyroid US except for some reports about the volume of thyroid nodules. [25][26][27] The current study showed a relatively high degree of consistency among multiple observers in US evaluation of thyroid nodules. The characteristic of internal content (solid versus cystic) showed substantial agreement, and the shape, echogenicity, calcification, and diagnostic categories showed moderate agreement.…”

Contemporary diagnostic approach to the thyroid nodule

“…It is important to note the anatomic landmarks, position the patient supine with the neck extended, and examine the entire region from the sternal notch to the chin and bilaterally to include both node-bearing regions. Newly developed threedimensional thyroid ultrasound may have a role in the evaluation of new nodular masses arising in patients with nodular goiter or other complex thyroid histologies [48,49], but is not widely available.…”