Maximal, minimal, and mean pulsed Doppler parameters: Which should be utilized in the diagnosis of thyroid nodules?

Ultrasonography Diagnosis and Imaging-Based Management of Thyroid Nodules: Revised Korean Society of Thyroid Radiology Consensus Statement and Recommendations

“…The presence of intranodular vascularity is variably observed in 16.7–91.7% of the malignant tumors ( 4 51 63 64 65 66 67 ) and 30.7–65.3% of the benign nodules ( 63 64 65 66 67 ). Although the presence of intranodular vascularity might increase the risk of malignancy ( 4 64 ), there are no consistent results regarding the association of an intranodular vascularity pattern with the risk of malignancy ( 63 66 67 68 ). Recent studies reported that the presence of intranodular vascularity was not predictive of the malignancy ( 25 67 ), and that it could not provide an added value over that of the gray-scale US alone for the prediction of the malignancies of the overall thyroid nodules ( 67 ).…”

“…Additionally, higher resistive index (RI) or pulsatility index Doppler index values might be predictive of malignancy. However, the cutoff value of each of the indices and their complementary role in the diagnosis of malignancies has not yet been established ( 68 ). Although the presence of a marked intranodular vascularity pattern might be predictive of malignancy in the follicular lesions or follicular neoplasm ( 69 70 71 72 73 ), the hypothesis remains controversial ( 74 ).…”

Investigation of the Effectiveness of Microvascular Doppler Ultrasound and Q-Pack in the Discrimination of Malign Thyroid Nodules From Benign

“…Therefore, they argued that following up the nodules with indeterminate grayscale US findings without significant vascularity on the alternative Doppler method instead of performing fine-needle biopsy would increase specificity 32 . It has also been reported in the literature that traditional Doppler US methods cannot provide enough data to distinguish between malignant and benign thyroid nodules 32–34 . Although the number of patients in our study was limited and the results were evaluated according to the results of FNAB rather than histopathology, MicroV Doppler US was considered a useful method in the differentiation of benign-malignant thyroid nodules in both our study and the literature samples mentioned previously.…”

“…32 It has also been reported in the literature that traditional Doppler US methods cannot provide enough data to distinguish between malignant and benign thyroid nodules. [32][33][34] Although the number of patients in our study was limited and the results were evaluated according to the results of FNAB rather than histopathology, MicroV Doppler US was considered a useful method in the differentiation of benign-malignant thyroid nodules in both our study and the literature samples mentioned previously. MicroV Doppler US is promising in showing microvascular structure and distribution that we normally cannot see with conventional Doppler methods.…”