Application of contrast-enhanced ultrasound for evaluation of thyroid nodules

Zhan, Jia; Ding, Hong

doi:10.14366/usg.18019

Cited by 45 publications

(55 citation statements)

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“…Hypoenhancement and heterogeneity describe malignant lesions, while homogeneity and the presence of an enhanced peripheral ring indicate a benign nodule. However, more research is necessary in this promising field [48][49][50].…”

Section: Discussionmentioning

confidence: 99%

TI-RADS Diagnostic Performance: Which Algorithm Is Superior and How Elastography and 4D Vascularity Improve the Malignancy Risk Assessment

et al. 2020

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Given the increased prevalence of thyroid nodules in the general population (~50%), the real challenge resides in correctly recognizing the suspicious ones. This study proposes to compare four important Thyroid Imaging and Reporting Data Systems (TI-RADS) and evaluate the contribution of elastography and 4D Color Doppler assessment of vascularity in estimating the risk of malignancy. In the study, 133 nodules with histopathological examination were included. Of these, 35 (26.31%) proved to be malignant. All nodules were classified using the four selected systems and our proposed improved score. The American College of Radiology (ACR) and EU TI-RADS had good sensitivity (94.28%, 97.14%) and NPV (93.33%, 95.83%), but fairly poor specificity (31.81%, 23.46%) and PPV (35.48%, 31.19%), with an accuracy of 42.8% and 45.8%, respectively. Horvath TI-RADS had better accuracy of 66.9% and somewhat improved specificity (62.24%), but poorer sensitivity (80%). Russ’ French TI-RADS includes elastography in the risk assessment strategy. This classification proved superior in all aspects (Se: 91.42%, Sp:82.65%, NPV:96.42%, PPV:65.30%, and Acc of 84.96%). The mean strain ratio (SR) value for malignant lesions was 5.56, while the mean SR value for benign ones was significantly lower, 2.54 (p < 0.05). It also correlated well with the response variable: histopathological result (p < 0.001). Although, adding 4D vascularity to the French score generated a similar calculated accuracy and from a statistical point of view, the parameter itself proved beneficial for predicting the malignancy risk (p < 0.001) and may add important knowledge in uncertain situations. Advanced ultrasound techniques definitely improved the risk estimation and should be used more extensively.

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Section: Discussionmentioning

confidence: 99%

TI-RADS Diagnostic Performance: Which Algorithm Is Superior and How Elastography and 4D Vascularity Improve the Malignancy Risk Assessment

et al. 2020

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“…US-guided lung biopsy has success rate similar to CT-guided biopsies (which is the gold standard) in the assessment of the cyto-histological diagnosis of peripheral lung lesions, but offers lower complications, less time, and less cost without radiation exposure (Frongillo et al, 2018;Sperandeo et al, 2019). A new US contrast agent, SonoVue, (Bracco SpA), has emerged in recent years for USguided biopsy of lesions of the liver (D'Onofrio et al, 2015), thyroid (Zhan and Ding, 2018), and mediastinal cancers (Fu et al, 2016), but it has also been proposed, off label, for the study of peripheral lung lesions in contact with the pleural surface (Cao et al, 2011;Dong et al, 2015;Sidhu et al, 2018).…”

Section: A Commentary Onmentioning

confidence: 99%

Commentary: Ultrasound-Guided Biopsy of Pleural-Based Pulmonary Lesions by Injection of Contrast-Enhancing Drugs

et al. 2020

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“…New-generation contrast agents (SonoVue) are administered intravenously and contain sulfur hexafluoride microbubbles that stay in the blood flow for a while. The examiner focuses the US image on the ROI and a contrastenhanced image is displayed, detecting microvascular changes in the lesion that classic Doppler cannot display [80].…”

Section: Contrast-enhanced Ultrasound (Ceus)mentioning

confidence: 99%

“…In studies where CEUS was performed on thyroid lesions, malignity was indicated by hypoenhancement and heterogeneity [80]. Hypoenhancement can be explained by the absence of blood supply in the central area of the tumor, due to thrombus formation, vascular compression, and necrosis.…”

Section: Contrast-enhanced Ultrasound (Ceus)mentioning

confidence: 99%

Advanced Ultrasound Techniques in Preoperative Diagnostic of Thyroid Cancers

Borlea¹,

Cotoi²,

Mozoş³

et al. 2019

Knowledges on Thyroid Cancer

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The most precise evaluation of thyroid masses is by high-sensitive ultrasound. Complementary to B-mode ultrasound, elastography can add valuable information by determining tissue stiffness-an important predictor for malignancy. All major guidelines recommend nodules with high suspicious ultrasound characteristics larger than 1 cm to be addressed to ultrasound-guided fine needle aspiration biopsy (FNAB) to rule out malignancy. The main limitation of this procedure is represented by indeterminate cytology, which accounts for up to 20-25% of biopsy results. Molecular markers imply elevated costs and their performance needs further study. Elastography may be helpful in establishing the optimal therapeutic attitude for this cytological category. Currently, there are two ultrasound elastography methods available for assessing tissue stiffness using the parallel deformation to the applied force direction (strain) or the perpendicular deformation to the force direction (shear wave). These methods will be presented and compared in this chapter, with their indications and limitations for a better understanding of their application in nodular thyroid pathology.

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Application of contrast-enhanced ultrasound for evaluation of thyroid nodules

Cited by 45 publications

References 50 publications

TI-RADS Diagnostic Performance: Which Algorithm Is Superior and How Elastography and 4D Vascularity Improve the Malignancy Risk Assessment

TI-RADS Diagnostic Performance: Which Algorithm Is Superior and How Elastography and 4D Vascularity Improve the Malignancy Risk Assessment

Commentary: Ultrasound-Guided Biopsy of Pleural-Based Pulmonary Lesions by Injection of Contrast-Enhancing Drugs

Advanced Ultrasound Techniques in Preoperative Diagnostic of Thyroid Cancers

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