Interobserver Variation for Ultrasound Determination of Thyroid Nodule Volumes

Brauer, V. F. H.; Eder, P.; Miehle, Konstanze; Wiesner, Thomas; Hasenclever, H.; Paschke, Ralf

doi:10.1089/thy.2005.15.1169

Cited by 118 publications

(53 citation statements)

References 37 publications

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“…In previous 2D ultrasound examinations of thyroid nodules, poor reproducibility was reported in the evaluation of echogenicity, borders and volume; while good reproducibility was found in the evaluation of presence of calcifications, central vessels or cystic components [23-26]. However 3D ultrasound in the present study proved to deliver overall good interobserver reproducibility in evaluation of thyroid nodule features.…”

Section: Discussioncontrasting

confidence: 53%

Advantages and disadvantages of 3D ultrasound of thyroid nodules including thin slice volume rendering

et al. 2011

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BackgroundThe purpose of this study was to assess the advantages and disadvantages of 3D gray-scale and power Doppler ultrasound, including thin slice volume rendering (TSVR), applied for evaluation of thyroid nodules.MethodsThe retrospective evaluation by two observers of volumes of 71 thyroid nodules (55 benign, 16 cancers) was performed using a new TSVR technique. Dedicated 4D ultrasound scanner with an automatic 6-12 MHz 4D probe was used. Statistical analysis was performed with Stata v. 8.2.ResultsMultiple logistic regression analysis demonstrated that independent risk factors of thyroid cancers identified by 3D ultrasound include: (a) ill-defined borders of the nodule on MPR presentation, (b) a lobulated shape of the nodule in the c-plane and (c) a density of central vessels in the nodule within the minimal or maximal ranges. Combination of features provided sensitivity 100% and specificity 60-69% for thyroid cancer.Calcification/microcalcification-like echogenic foci on 3D ultrasound proved not to be a risk factor of thyroid cancer.Storage of the 3D data of the whole nodules enabled subsequent evaluation of new parameters and with new rendering algorithms.ConclusionsOur results indicate that 3D ultrasound is a practical and reproducible method for the evaluation of thyroid nodules. 3D ultrasound stores volumes comprising the whole lesion or organ. Future detailed evaluations of the data are possible, looking for features that were not fully appreciated at the time of collection or applying new algorithms for volume rendering in order to gain important information. Three-dimensional ultrasound data could be included in thyroid cancer databases. Further multicenter large scale studies are warranted.

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Section: Discussioncontrasting

confidence: 53%

Advantages and disadvantages of 3D ultrasound of thyroid nodules including thin slice volume rendering

et al. 2011

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“…Even with T 4 +I, nodular volume increased in 25% of patients, whereas 16% showed volume decreases greater than 50%, also suggesting heterogeneity of responses and/or pathophysiology (Supplemental Table 3). The intraobserver variability of thyroid nodule volume measurements observed in parallel phantom measurements was high (11%), as previously demonstrated by Brauer et al (30), thus providing good reason to investigate much higher numbers of patients per group than those enrolled in any previous (lesser powered) trials.…”

Section: Discussionsupporting

confidence: 67%

Reduction of Thyroid Nodule Volume by Levothyroxine and Iodine Alone and in Combination: A Randomized, Placebo-Controlled Trial

Grußendorf

Reiners

Paschke

et al. 2011

The Journal of Clinical Endocrinology &Amp; Metabolism

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Context:Nodular goiter is common worldwide, but there is still debate over the medical treatment.Objective:The objective of the study was the measurement of the effect of a treatment with (nonsuppressive) T4, iodine, or a combination of both compared with placebo on volume of thyroid nodules and thyroid.Design:This was a multicenter, randomized, double-blind trial in patients with nodular goiter in Germany [LISA (Levothyroxin und Iodid in der Strumatherapie Als Mono-oder Kombinationstherapie) trial].Setting:The study was conducted in outpatient clinics in university hospitals and regional hospitals and private practices.Participants:One thousand twenty-four consecutively screened and centrally randomized euthyroid patients aged 18–65 yr with one or more thyroid nodules (minimal diameter 10 mm) participated in the study.Intervention:Intervention included placebo, iodine (I), T4, or T4+I for 1 yr. T4 doses were adapted for a TSH target range of 0.2–0.8 mU/liter.Outcome Measures:The primary end point was percent volume reduction of all nodules measured by ultrasound, and the main secondary end point was a change in goiter volume.Results:Nodule volume reductions were −17.3% [95% confidence interval (CI) −24.8/−9.0%, P < 0.001] in the T4+I group, −7.3% (95% CI −15.0/+1.2%, P = 0.201) in the T4 group, and −4.0% (95% CI −11.4/+4.2%, P = 0.328) in the I group as compared with placebo. In direct comparison, the T4+I therapy was significantly superior to T4 (P = 0.018) or I (P = 0.003). Thyroid volume reductions were −7.9% (95% CI −11.8/−3.9%, P < 0.001), −5.2% (95% CI −8.7/−1.6%, P = 0.024) and −2.5% (95% CI −6.2/+1.4%, P = 0.207), respectively. The T4+I therapy was significantly superior to I (P = 0.034) but not to T4 (P = 0.190).Conclusion:In a region with a sufficient iodine supply, a 1-yr therapy with a combination of I and T4 with incomplete suppression of thyrotropin reduced thyroid nodule volume further than either component alone or placebo.

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“…This in turn is meant to guide future FNA decision-making based on either a 20% increase in at least two of the three nodular dimensions and/or development of suspicious US characteristics [1, 14, 22, 23]. Therefore, an initial precisely descriptive platform report that includes three axis dimensions and specific localization of any nodule targeted for follow-up is extremely essential for serial comparison, and its value cannot be overstated [14].…”

Section: Discussionmentioning

confidence: 99%

Thyroid Ultrasound Reports: Deficiencies and Recommendations

2019

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Objective: Thyroid ultrasound plays a major role in the clinical management of patients with thyroid nodules. Comprehensive reporting enables malignant risk stratification and biopsy decisions. In this study, we aimed at a systematic evaluation of the content and completeness of thyroid radiology reports. Methods: A retrospective study was undertaken. A total of 200 thyroid ultrasound reports of examinations performed over a 1-year period were reviewed. After excluding 18 reports, the remaining 182 were evaluated for the inclusion of the following nodule characteristics: size, 3-axis dimensions, location, presence or absence of five signs suspicious of malignancy, namely microcalcification, hypoechogenecity, irregular margin, height-to-width ratio, and intranodular vascularity. Results: While all reported nodules could be stratified easily as being more or less than 1 cm in size, only 23.6% of these nodules were reported in 3 dimensions, and 33.5% of the nodules were specifically localized. For any described nodule, the frequency of reporting on echogenicity was 50%, on vascularity 19.2%, on margin 10.4%, on calcifications 9.3%, and no report contained a description of the height-to-width ratio. The cumulative frequency of reporting on one characteristic per nodule was 84%, of two characteristics 27%, three characteristics 4.4%, and no report included ≥4 characteristics per nodule. Conclusion: Despite easily accessible templates, reporting of thyroid nodule sonogram continues to be incomplete and inconsistent. This in turn constitutes a waste of a significant tool that could otherwise help in making timely informed medical decisions and in providing a significant platform for patients’ future follow-up.

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Interobserver Variation for Ultrasound Determination of Thyroid Nodule Volumes

Cited by 118 publications

References 37 publications

Advantages and disadvantages of 3D ultrasound of thyroid nodules including thin slice volume rendering

Advantages and disadvantages of 3D ultrasound of thyroid nodules including thin slice volume rendering

Reduction of Thyroid Nodule Volume by Levothyroxine and Iodine Alone and in Combination: A Randomized, Placebo-Controlled Trial

Thyroid Ultrasound Reports: Deficiencies and Recommendations

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