Combining real-time elastography with fine-needle aspiration biopsy to identify malignant thyroid nodules

Zhu, Lei; Chen, Yanyan; Ai, Huijun; Gong, Wei; Zhou, Bin; Xu, Yonghong; Chen, Shuzheng; Cheng, Feng

doi:10.1177/0300060520976027

Cited by 8 publications

(7 citation statements)

References 26 publications

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“…Sengul et al ( 31 ) found that SE score could affect the clinical decision-making for patients with indeterminate FNA cytology. Zhu et al ( 32 ) reported that a high SE score was a significant predictor for malignancy. However, SE was challenged and criticized due to its operator dependency ( 34 ).…”

Section: Discussionmentioning

confidence: 99%

“…In recent years, elastography has become available for thyroid nodule evaluation as reported in many studies, which is emerging as a potential method for the differentiation of benign and malignant thyroid nodules and may provide additional information to support clinical decision-making (29). Some studies (30)(31)(32)(33) reported that strain elastography (SE) was useful for the prediction of malignancy and differentiation of thyroid nodules with indeterminate FNA cytology. Sengul et al (31) found that SE score could affect the clinical decision-making for patients with indeterminate FNA cytology.…”

Section: Discussionmentioning

confidence: 99%

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Contrast-enhanced ultrasound and shear wave elastography in the diagnosis of ACR TI-RADS 4 and 5 category thyroid nodules coexisting with Hashimoto’s thyroiditis

Wang

Yang

et al. 2023

Front. Oncol.

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ObjectiveThis study aims to evaluate the value of contrast-enhanced ultrasound (CEUS), shear wave elastography (SWE), and their combined use in the differentiation of American College of Radiology (ACR) thyroid imaging reporting and data system (TI-RADS) 4 and 5 category thyroid nodules coexisting with Hashimoto’s thyroiditis (HT).Materials and methodsA total of 133 pathologically confirmed ACR TI-RADS 4 and 5 category nodules coexisting with HT in 113 patients were included; CEUS and SWE were performed for all nodules. The sensitivity, specificity, negative predictive value (NPV), positive predictive value (PPV), accuracy, and the area under the receiver operating characteristic curve (AUC) of the SWE, CEUS, and the combined use of both for the differentiation of benign and malignant nodules were compared, respectively.ResultsUsing CEUS alone, the sensitivity, specificity, PPV, NPV, and accuracy were 89.2%, 66.0%, 81.3%, 78.6%, and 80.5%, respectively. Using SWE alone, Emax was superior to Emin, Emean, and Eratio for the differentiation of benign and malignant nodules with the best cutoff Emax >46.8 kPa, which had sensitivity of 65.1%, specificity of 90.0%, PPV of 91.5%, NPV of 60.8%, and accuracy of 74.4%, respectively. Compared with the diagnostic performance of qualitative CEUS or/and quantitative SWE, the combination of CEUS and SWE had the best sensitivity, accuracy, and AUC; the sensitivity, specificity, PPV, NPV, accuracy, and AUC were 94.0%, 66.0%, 82.1%, 86.8%, 83.5%, and 0.80 (95% confidence interval: 0.713, 0.886), respectively.ConclusionIn conclusion, CEUS and SWE were useful for the differentiation of benign and malignant ACR TI-RADS 4 and 5 category thyroid nodules coexisting with HT. The combination of CEUS and SWE could improve the sensitivity and accuracy compared with using CEUS or SWE alone. It could be a non-invasive, reliable, and useful method to differentiate benign from malignant ACR TI-RADS 4 and 5 category thyroid nodules coexisting with HT.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Contrast-enhanced ultrasound and shear wave elastography in the diagnosis of ACR TI-RADS 4 and 5 category thyroid nodules coexisting with Hashimoto’s thyroiditis

Wang

Yang

et al. 2023

Front. Oncol.

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“…With the advancement of diagnostic techniques for thyroid malignancies ( 20 , 21 ), there is a rising trend in the number of patients requiring thyroid surgery. IONM technology has been widely utilized in thyroid surgery to real-time monitor the function of the recurrent laryngeal nerve.…”

Section: Discussionmentioning

confidence: 99%

A study on the appropriate dose of rocuronium for intraoperative neuromonitoring in Da Vinci robot thyroid surgery: a randomized, double-blind, controlled trial

Lan,

Huang,

et al. 2023

Front. Endocrinol.

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BackgroundThis study was to explore the effect of different doses of rocuronium bromide on neuromonitoring during Da Vinci robot thyroid surgery.MethodsThis was a prospective, randomized, double-blind, controlled trial that included 189 patients who underwent Da Vinci robot thyroidectomy with intraoperative neuromonitoring(IONM). Patients were randomly divided into three groups and given three different doses of rocuronium (0.3mg/kg, 0.6mg/kg, 0.9mg/kg). Outcome measurements included IONM evoked potential, postoperative Voice Handicap Index-30(VHI-30), intraoperative body movement incidence rate, Cooper score, and hemodynamic changes during anesthesia induction.Results: The difference in IONM evoked potentials at various time points between the three groups was not statistically significant (P>0.05). The difference in Cooper scores and intraoperative body movement incidence rate between 0.6 and 0.9mg/kg groups was statistically significant compared with the 0.3mg/kg group (both P<0.001). There was no statistically significant difference in VHI-30 score and hemodynamic changes during anesthesia induction among the three groups (both P>0.05).ConclusionsFor patients undergoing Da Vinci robot thyroidectomy, a single dose of rocuronium at 0.6 and 0.9mg/kg during anesthesia induction can provide stable IONM evoked potential. Additionally, compared to 0.3 mg/kg, it can offer better tracheal intubation conditions and lower incidence of body movements during surgery. It is worth noting that the use of higher doses of rocuronium should be adjusted based on the duration of IONM and local practices.

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“…The above‐mentioned studies investigated elastography before FNA. Additionally elastography can also be used in combination with FNA to improve the final diagnostic accuracy, as studied by Zhu et al 94 This might be problematic for the indeterminate nodules, however Qiu et al found in their systematic review that shear‐wave elastography and strain ratio elastography are more efficient for differentiation of indeterminate thyroid nodules 95 . In addition, they concluded that the combination of elastography and other ultrasound techniques improves evaluation of indeterminate thyroid nodules 95 .…”

Section: Diagnosismentioning

confidence: 99%

Ultrasound imaging in thyroid nodule diagnosis, therapy, and follow‐up: Current status and future trends

Boers

Braak

Rikken

et al. 2023

J of Clinical Ultrasound

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Ultrasound, the primary imaging modality in thyroid nodule management, suffers from drawbacks including: high inter-and intra-observer variability, limited field-of-view and limited functional imaging. Developments in ultrasound technologies are taking place to overcome these limitations, including three-dimensional-Doppler, -elastography, -nodule characteristics-extraction, and novel machine-learning algorithms. For thyroid ablative treatments and biopsies, perioperative use of three-dimensional ultrasound opens a new field of research. This review provides an overview of the current and future applications of ultrasound, and discusses the potential of new developments and trends that may improve the diagnosis, therapy, and follow-up of thyroid nodules.

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Combining real-time elastography with fine-needle aspiration biopsy to identify malignant thyroid nodules

Cited by 8 publications

References 26 publications

Contrast-enhanced ultrasound and shear wave elastography in the diagnosis of ACR TI-RADS 4 and 5 category thyroid nodules coexisting with Hashimoto’s thyroiditis

Contrast-enhanced ultrasound and shear wave elastography in the diagnosis of ACR TI-RADS 4 and 5 category thyroid nodules coexisting with Hashimoto’s thyroiditis

A study on the appropriate dose of rocuronium for intraoperative neuromonitoring in Da Vinci robot thyroid surgery: a randomized, double-blind, controlled trial

Ultrasound imaging in thyroid nodule diagnosis, therapy, and follow‐up: Current status and future trends

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