Advanced multimodal imaging of solid thyroid lesions with artificial intelligence-optimized B-mode, elastography, and contrast-enhanced ultrasonography parametric and with perfusion imaging: Initial results

Abstract

Goal of the study was the assessment of AI-assisted diagnosis of solid thyroid foci with multimodal modern ultrasound imaging. 50 patients (26–81 years, 54.7±13.1 years) were included in the study. Multimodal ultrasound imaging by means of B-mode with linear probe (4–12 MHz) with option of automated documentation of findings by means of AI, with supplementary Ultra MicroAngiography (UMA) was used. Macrovascularisation was assessed by dynamic contrast ultrasonography (CEUS) with parametric evaluation and perfusion analysis, and microvascularization was assessed by combined strain and shear wave elastography on a novel high-performance ultrasound system (Resono R9/Mindray) by an experienced examiner with independent reading. The evaluation was performed according to TI-RADS III-V. The volume of the thyroid lobes on both sides averaged 39 ml±5 ml (27 to 69 ml). The 13 cases of histologically confirmed thyroid carcinomas (8 papillary, 2 medullary, 2 microfollicular, 1 anaplastic CA) with a mean size of 15 mm±6 mm (9–21 mm) were correctly evaluated by TI-RADS V on the basis of irregular shape, induration > 2.5 m or > 30kPA and striking wash-out kinetics. Tumor lymph nodes could only be correctly detected preoperatively in one case of medullary carcinoma according to the surgical findings, based on irregular vascularization with UMA in roundish shape with cortex > 4 mm, transverse diameter up to 11 mm. In 25 cases of inhomogeneous nodular goiter an evaluation with TI-RADS III was performed in 31 cases, in 4 cases with incomplete marginal contour, partial marginal vascularization with UMA and partial wash out with indurations up to 2.5 m/s 30 kPA an evaluation with TI-RADS IV and surgical excision for nodular goiter. In 12 cases regressive nodular changes without relevant malignancy criteria resulted in nodular goiter, with focal changes up to 1.5 cm in diameter, classified as requiring control with TI-RADS III. There were no relevant changes in findings in the controls after 6 months. From the AI tool, the 20/25 goiter nodes were assessed as TI-RADS III, 7/12 adenomas, 5 goiter nodes, and 5 adenomas as TI-RADS IV, 5/13 carcinomas as TI-RADS IV, and 8/13 carcinomas as TI-RADS V. Multimodal ultrasound diagnostics supported by AI has a high diagnostic potential for the evaluation of solid thyroid lesions and standardizes the reporting with digital representative image documentation. CEUS perfusion and modern elastography techniques allow targeted follow-up of TI-RADS III findings.

Smart scanning: automatic detection of superficially located lymph nodes using ultrasound – initial results

“…Research on the integration of AI into ultrasound as well as other imaging methods is increasingly becoming a focus of various disciplines [24,25]. In the field of ultrasound, most studies analyze whether the integration of AI can improve the differential diagnosis of lesions, for example of the thyroid gland [14,15,16,17] or the breast [12,13].…”

“…Research on the additional assessment of sonographic findings using AI has been steadily increasing in recent years. Applications have been described in particular for the assessment of breast lesions [12,13], the thyroid gland [14,15,16,17], as well as for cardiac ultrasound [18]. One particular difficulty for the successful application of AI in the assessment of ultrasound images is the high variability in the quality and settings of the respective find-ings [19].…”

Initial description of the novel handheld wireless ultrasound device TE Air with Doppler and Color Duplex imaging

“…Ultrasound diagnostics represents an important cornerstone of imaging diagnostics in many medical fields [1,2]. Using the latest high-end ultrasound techniques, highly effective means for abdominal diagnostics are available [3][4][5][6][7]. Apart from the very high equipment costs, the size and bulkiness of these devices (e.g., limited freedom of movement of the monitor screen) pose a challenge that should not be underestimated [8,9].…”

New aspects of high-resolution ultrasound for tumor detection and treatments: M-Elite Program

“…By taking part in initiatives based on this concept, physicians would have the chance to directly explore and evaluate the most up-to-date ultrasound technology for both diagnostic purposes and ultrasound-guided interventions during patient examinations at university ultrasound centres in China. The exchange of knowledge with fellow professionals and system developers would also be a significant component of this experience [1][2][3][4][5][6][7][8][9][10][11].This concept was deliberated in small group discussions and individual meetings, focusing on forthcoming advancements in technology. Subsequently, there was an in-depth exploration of standards for scientific publications and environmentally conscious aspects of science and technology.…”

“…By taking part in initiatives based on this concept, physicians would have the chance to directly explore and evaluate the most up-to-date ultrasound technology for both diagnostic purposes and ultrasound-guided interventions during patient examinations at university ultrasound centres in China. The exchange of knowledge with fellow professionals and system developers would also be a significant component of this experience [1][2][3][4][5][6][7][8][9][10][11].…”