Thyroid Gland Tumor Diagnosis at US Elastography

Lyshchik, Andrej; Higashi, Tatsuya; Asato, Ryo; Tanaka, Shinzo; Ito, Juichi; Jerome, J. Terrence Jose; Pellot‐Barakat, Claire; Insana, Michael F.; Brill, A.B.; Saga, Tsuneo; Hiraoka, Masahiro; Togashi, Kaori

doi:10.1148/radiol.2363041248

Cited by 582 publications

(435 citation statements)

References 18 publications

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“…Realtime elastography (RTE) a qualitative method has been evaluated in a number of studies [8][9][10][11][12][13][18][19][20]. A recent meta-analysis performed by Bojunga et al [13] summarizes the results of several studies reporting a global sensitivity and specificity of 92 and 90 %, respectively, for RTE in the diagnosis of malignant thyroid nodules.…”

Section: Discussionmentioning

confidence: 99%

Prospective evaluation of acoustic radiation force impulse technology in the differentiation of thyroid nodules: accuracy and interobserver variability assessment

et al. 2014

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Purpose The aim of this study is to assess the diagnostic efficacy and interobserver agreement of acoustic radiation force impulse (ARFI) elasticity imaging in differentiating thyroid nodules. Methods In our study, 74 consecutive patients (52 females, 22 males; age range 27-77 years, mean: 41 years) with 82 thyroid nodules (60 benign nodules, and 22 malignant) were examined by two radiologists with different experience. Patients underwent either cytology using fine needle aspiration cytology or thyroid surgery. The diagnostic performance of the two operators at ARFI with sensitivity, specificity, positive predictive and negative predictive value, and ROC curves was estimated. Interreader variability between the two operators was defined using Cohen's k.Results According to receiver operating characteristics ROC curves (AUROC = 0.86 for observer 1; 0.81 for observer 2) sensitivity, specificity, PPV and NPV of reader 1 and 2 were respectively: 90, 75, 90.91 and 96.55 %; (cutoff value of shear wave: 2.455 m/s); 90, 72, 90 and 96.90 % (cut-off value shear wave: 2.365 m/s). Concordance between the two operators was good (k = 0.755). Conclusions This work is a feasibility study evaluating ARFI imaging. Its results suggest that ARFI imaging is a reproducible method which can be utilized with good diagnostic performance in the thyroid for discriminating benign and malignant nodules using the cut-off value of 2.455 m/s. However, larger studies are needed to validate this method.Keywords Acoustic radiation force impulse (ARFI) Á Elastography Á Benign thyroid nodules Á Malignant thyroid nodules Á Ultrasound Riassunto Scopo Lo scopo di questo studio è la valutazione della efficacia diagnostica e della concordanza inter-osservatore dell'imaging elastografico ARFI, per la differenziazione di noduli tiroidei. Metodo Nel nostro studio, 74 pazienti consecutivi (52 femmine, 22 maschi; range di età 22-77 anni, età media 41 anni) con 82 noduli tiroidei (60 noduli benigni e 22 maligni), sono stati esaminati da due radiologi con diverso livello di esperienza. I pazienti sono stati sottoposti o a citologia aspirativa con ago sottile (FNAC), o a chirurgia tiroidea. La performance diagnostica dei due operatori all' ARFI è stata stimata con la sensibilità, la specificità, il valore predittivo positivo (VPP) e negativo (VPN), attraverso le curve ROC (receiver operating characteristics). La variabilità inter-osservatore tra i due operatori, è stata definita usando la kappa di Cohen. (2014( ) 17:13-20 DOI 10.1007 Risultati Secondo le curve ROC (AUROC = 0.86 per il primo osservatore; 0.81 per il secondo osservatore) la sensibilità, la specificità, il VPP e il VPN per gli osservatori 1 e 2, erano rispettivamente: 90, 75, 90,91, e 96.55 %; (valore medio di shear wave: 2.455 m/s); 90, 72, 90 e 96.90 % (valore medio di shear wave: 2.365 m/s). La concordanza tra I due operatori era buona (k = 0.755). Conclusioni Questo lavoro è uno studio preliminare che valuta l'imaging elastografico con Acustic Radiation Force Impulse. I risultati sug...

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Section: Discussionmentioning

confidence: 99%

Prospective evaluation of acoustic radiation force impulse technology in the differentiation of thyroid nodules: accuracy and interobserver variability assessment

et al. 2014

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“…For these reasons, sonoelastography has recently been used for the study of thyroid nodules. Lyshchik et al [1] obtained promising results with an experimental technique and equipment, which were highly interesting within a research context, but the approach they used is too complex and time-consuming for routine use in clinical practice. In contrast, Bae et al [11] have proposed an alternative to the widely used approach that involves manual compression.…”

Section: Clinical Applications Thyroidmentioning

confidence: 99%

The role of sonoelastography in the differential diagnosis of neck nodules

Rubaltelli

Stramare

Tregnaghi

et al. 2009

Journal of Ultrasound

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KEYWORDSTechnology assessment; Thyroid; Tumor.Abstract Sonoelastography is an imaging technique that provides information on tissue elasticity. Its use as a diagnostic procedure is based on the premise that pathological processes like cancer alter the physical characteristics of the involved tissue. Ultrasonographic studies of the neck can reveal the nonpalpable thyroid nodules, but the nature of these lesions generally has to be established on the basis of FNAB findings. In our hands, sonoelastography displayed a diagnostic accuracy of 86.2% in identifying thyroid nodule malignancy, with positive and negative predictive values (PPV and NPV) of 64% and 94.5%, respectively. In the study of cervical lymph nodes, the results were less impressive (sensitivity 75%, specificity 80%, accuracy 77%, PPV 80%, NPV 70%), but the information obtained with this technique can in our opinion be a useful adjunct to sonographic findings. Indeed, in 5 lymph nodes with sonographic features consistent with malignancy, sonoelastography revealed diffuse elasticity that was indicative of benign disease, which was confirmed by pathological studies. Other nodular lesions of the neck can also be evaluated with sonoelastography, including enlarged parotid glands, but the data in the literature are too limited to allow hypotheses on the role of this imaging modality in this field. Sonoelastography is rapid and simple to perform, and it appears to be a potentially useful tool for the differential diagnosis of neck nodules. This is particularly true of thyroid nodules. Our experience with these lesions indicates that diffuse elasticity is strongly correlated with benign disease. If this finding is confirmed in larger studies, sonoelastography might be used to identify thyroid nodules that do not require immediate biopsy.Sommario L'elastosonografia è una tecnica di imaging che fornisce informazioni relative alla elasticità dei tessuti e che può essere utilizzata nella pratica clinica basandosi sul presupposto che i processi patologici, come il cancro, inducono modificazioni della caratteristiche fisiche dei tessuti ammalati. Lo studio ecografico della loggia cervicale permette di individuare formazioni nodulari non palpabili all'interno della tiroide, tuttavia l'accuratezza diagnostica di questa tecnica è scarsa e per tale motivo il ricorso alla FNAB è spesso necessario. Nella nostra esperienza l'elastosonografia ha dimostrato, nella diagnosi differenziale dei nodi tiroidei, un'accuratezza diagnostica del 86,2% con VPN 94,5% e VPP 64%. Nello studio dei linfonodi cervicali i risultati ottenuti sono meno brillanti (sensibilità, specificità e accuratezza rispettivamente del 75%, 80% e 77% con VPP e VPN di 80% e 70%), ma riteniamo che le informazioni ottenibili possono in molti casi essere utili per integrare i dati ecografici; in particolare in 5 casi di linfonodi con caratteristiche morfo-strutturali indicative di malignità, l'elastosonografia ha dimostrato un pattern di completa elasticità, riconoscendo la natura benigna confermata dalle succes...

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“…On the elastogram, soft areas usually appear red or yellow and hard areas appear blue. UE has been used on several organs: breast (Itoh et al, 2006;Thomas et al, 2006), thyroid (Lyshchik et al, 2005), prostate (Taylor et al, 2005), liver (Friedrich-Rust et al, 2007;Thomas et al, 2007) and skin (Iagnocco et al, 2010). But on cervical LNs, there were few researches, such as Lyshchik et al (2007), Farzana Alam et al (2008) and Rong Tan et al (2010).…”

Section: Introductionmentioning

confidence: 99%

Value of Ultrasound Elastography in Assessment of Enlarged Cervical Lymph Nodes

Teng

Wang²,

Lin³

et al. 2012

Asian Pacific Journal of Cancer Prevention

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Background: To investigate the value of ultrasound elastography (UE) in the differentiation between benign and malignant enlarged cervical lymph nodes (LNs). Methods: B-mode ultrasound, power Doppler imaging and UE were examined to determine LN characteristics. Two kinds of methods, 4 scores of elastographic classification and a strain ratio (SR) were used to evaluate the ultrasound elastograms. Results: The cutoff point of SR had high utility in differential diagnosis of benign and malignant of cervical lymph nodes, with good sensitivity, specificity and accuracy. Conclusion: UE is an important aid in differential diagnosis of benign and malignant cervical LNs.

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Thyroid Gland Tumor Diagnosis at US Elastography

Abstract: Elastography is a promising imaging technique that can assist in the differential diagnosis of thyroid cancer.

Cited by 582 publications

References 18 publications

Prospective evaluation of acoustic radiation force impulse technology in the differentiation of thyroid nodules: accuracy and interobserver variability assessment

Prospective evaluation of acoustic radiation force impulse technology in the differentiation of thyroid nodules: accuracy and interobserver variability assessment

The role of sonoelastography in the differential diagnosis of neck nodules

Value of Ultrasound Elastography in Assessment of Enlarged Cervical Lymph Nodes

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