Quantitative Analysis of Tumor Vascularity in Benign and Malignant Solid Thyroid Nodules

Lyshchik, Andrej; Moses, Rebecca; Barnes, Stephanie L.; Higashi, Tatsuya; Asato, Ryo; Miga, Michael I.; Gore, John C.; Fleischer, Arthur C.

doi:10.7863/jum.2007.26.6.837

Cited by 54 publications

(55 citation statements)

References 15 publications

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“…In contrast, other studies have reported that certain characteristics on Doppler US including vascular pattern, resistive index (RI) and maximal systolic velocity (MSV) are not useful parameters for distinguishing malignant from benign solid nodules (24)(25)(26). These characteristics, therefore, should not be used as diagnostic tools to determine which nodules should undergo FNAB (27).…”

Section: Thyroid Ultrasonographymentioning

confidence: 87%

Latin American Thyroid Society recommendations for the management of thyroid nodules

Camargo

Corigliano

Friguglietti

et al. 2009

Arq Bras Endocrinol Metab

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Several guidelines on diagnosis and treatment of thyroid nodules and cancer have recently been published. However, recommended practices are not always appropriate to different settings or countries. The aim of this consensus was to develop Clinical Guidelines for evaluation and management of patients with thyroid nodules applicable to Latin American countries. The panel was composed by 13 members of the Latin American Thyroid Society involved with research and management of thyroid nodules and cancer from different medical centers in Latin America. The consensus was produced based on the expert opinion of the panel with use of principles of evidence-based medicine. Following a group meeting, a first draft based on the expert opinion of the panel was elaborated and later circulated among panel members for further revision. After revision, this document was submitted to all LATS members for commentaries and considerations and finally revised and refined by the authors. The final recommendations represent state of the art on management of thyroid nodules applied to all Latin American countries. Arq Bras Endocrinol Metab. 2009;53(9):1167-75 Keywords Thyroid nodule; thyroid ultrasonography; thyroid aspiration biopsy; radioactive iodine therapy resumo Vários consensos têm sido publicados acerca do diagnóstico e do tratamento de nódulos e cân-cer da tireoide. Entretanto, as recentes recomendações nem sempre são apropriadas para diferentes regiões ou países. O objetivo deste trabalho foi oferecer uma série de recomendações para a avaliação e conduta de pacientes portadores de nódulos tireoideos aplicáveis a todos os países da América Latina. O trabalho foi realizado por um comitê composto por 13 membros da Sociedade Latino-Americana de Tireoide envolvidos com pesquisa e manejo de pacientes portadores de nódulos e carcinoma diferenciado da tireoide, de diferentes centros médicos da América Latina. As recomendações foram estabelecidas, após consenso, utilizando as opiniões especializadas de cada membro e os princípios da medicina baseada em evidência. Após a primeira reunião do grupo, um primeiro documento foi elaborado e encaminhado a todos os membros para revisão. Posteriormente, o documento foi enviado aos membros da Sociedade Latino-Americana de Tireoide para avaliação, sugestões e comentários. A versão final, elaborada após refinada revisão de todos os autores, representa o estado da arte no diagnóstico e na conduta de nódulos tireoideos, aplicáveis a todos os países da América Latina.

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Section: Thyroid Ultrasonographymentioning

confidence: 87%

Latin American Thyroid Society recommendations for the management of thyroid nodules

Camargo

Corigliano

Friguglietti

et al. 2009

Arq Bras Endocrinol Metab

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“…Subjects with simple goiter, non-autoimmune thyroid blood flow, but remains highly subjective and is not sufficient enough to evaluate subtle variations of thyroid vascularity. Several techniques for semi-quantitative measurements of intrathyroidal blood flow have been applied for the differentiation of painless thyroiditis from Graves' disease (10), and benign from malignant thyroid nodules (11). Similar techniques have been used for measurements of thyroid vascularity in healthy subjects (12), and in patients with subacute thyroiditis (13).…”

Section: Subjects Selectionmentioning

confidence: 99%

Prognostic value of vascularity index for the diagnosis of autoimmune thyroid disease

Banaka

Kaltsas

Antoniou

et al. 2011

Journal of the Belgian Society of Radiology

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Aim: to determine thyroid vascularity in healthy subjects and patients with autoimmune thyroid disease (AITD), and assess its sensitivity and specificity for the diagnosis of AITD. Methods: High-sensitivity color flow Doppler sonography (HSCFDS) was used to estimate the thyroid intraparenchymal vascularity in 31 euthyroid patients with Hashimoto's thyroiditis (HD), 33 hypothyroid patients with HD, 13 hyperthyroid patients with Graves' disease, and in 34 healthy controls. Images obtained from the ultrasound unit were further processed with a widespread, available imaging analysis program and the predictive value of the maximum vascularity index (VI) was used for further statistical analysis. Results: Compared to healthy controls, patients with AITD had higher mean VI of both the right and the left thyroid lobe (TL) (P < 0.001). The sensitivity of left TL VI values greater than 5.57% (the best cut-off value of the Receiver Operating Characteristics-ROC curve) for the diagnosis of AITD was 80.8% and the specificity was 85.3%. Right TL VI values greater than 14.75% had 84.6% sensitivity and 86.2% specificity for the differential diagnosis among patients with HT or GD. Conclusions: Measurement of right and left TL vascularity index using HSCFDS is a high specific tool, particularly where there is a high clinical suspicion of an autoimmune process.

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“…Additionally, other studies have shown that malignant nodules are more likely to have internal vascularity while benign nodules are more likely to have peripheral vascularity (17,21,25). Further analysis is necessary to determine if specific patterns and types of internal or peripheral vascularity are associated with various thyroid malignancies.…”

Section: Discussionmentioning

confidence: 99%

“…Brunese et al (20) explained that this is due to psammoma bodies, which are around collections of calcifications commonly found in tumors such as papillary thyroid cancer. Others suggest that smaller nodules with vascularity are better predictors of malignancy (21). Further analysis of other suspicious features of malignancy alone and in conjunction with one another is necessary to determine if they may be more accurate predictors of malignancy.…”

Section: Discussionmentioning

confidence: 99%

“…Future studies are warranted to investigate the predictive role of such characteristics, including the degree of nodule vascularity, in diagnosing suspicious thyroid nodules as malignant or not. Multiple studies (3,8,9,(15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25)(26) reviewed suggest that no individual ultrasound feature accurately differentiates benign and malignant nodules. Multiple suspicious features, however, do correlate with increased risk of malignancy.…”

Section: Discussionmentioning

confidence: 99%

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Is vascular flow a predictor of malignant thyroid nodules? A meta-analysis

Khadra¹,

Bakeer²,

Hauch³

et al. 2016

Gland Surg.

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Background: Several reports have proposed that increased vascular flow on color Doppler sonography may be associated with malignancy in thyroid nodules. Others have described no correlation between the presence of flow and risk of malignancy. The purpose of this study was to determine whether the vascularity of a thyroid nodule can aid in the prediction of malignancy by performing a meta-analysis of the current literature.Methods: Independent reviewers conducted a systematic review of publications from PubMed, EMBASE, and the Cochrane Database of Systematic Review using the following keyword searches: "vascular thyroid nodule", and "vascular malignant thyroid nodule". Outcomes included vascular flow pattern, nodule size, calcifications, echogenicity, margins, and shape. Data were extracted following review of appropriate studies, and outcome differences were calculated using analysis of variance and the Bonferroni method.Results: Eighty-nine publications were identified and 14 prospective studies met inclusion criteria totaling 4,154 thyroid nodules, 1,419 (34%) of which were malignant. Thirty-three percent of malignant thyroid nodules had no vascular flow, while 17% had peripheral and 50% had internal vascular flow. There was no significant difference in vascular flow (95% CI: −14.329, 4.257), or peripheral vascular flow rate between malignant and benign thyroid nodules (95% CI: −29.254, 4.313). Also, there was no significant difference in internal vascularity between malignant and benign thyroid nodules (95% CI: −72.067, 2.824).Conclusions: It appears that utilization of vascular flow on color Doppler sonography may not accurately predict malignancy in thyroid nodules. Further studies are warranted to investigate the predictive role of increased vascularity in diagnosing suspicious thyroid nodules.

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Quantitative Analysis of Tumor Vascularity in Benign and Malignant Solid Thyroid Nodules

Abstract: Our study indicates that in small thyroid nodules, quantitative analysis of tumor vascularity has benefits over visual inspection and can be useful in differentiation between benign and malignant thyroid tumors.

Cited by 54 publications

References 15 publications

Latin American Thyroid Society recommendations for the management of thyroid nodules

Latin American Thyroid Society recommendations for the management of thyroid nodules

Prognostic value of vascularity index for the diagnosis of autoimmune thyroid disease

Is vascular flow a predictor of malignant thyroid nodules? A meta-analysis

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