Is Ultrasonography More Sensitive Than Computed Tomography for Identifying Calcifications in Thyroid Nodules?

Li, Jia Wei; Chang, Cai; Chen, Min; Zeng, Wei; Gao, Yi; Zhou, Shi; Wang, Fen; Hu, Na; Chen, Ya Ling

doi:10.7863/ultra.15.10060

Cited by 7 publications

(8 citation statements)

References 29 publications

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“…On conventional gray-scale US, spongiform and cystic features seem to provide sufficient information to confidently rule out cancer (29) and calcification is regarded as a significant indicator of malignancy (30). In the current study, on conventional gray-scale US only 'micro-calcification' was included in the final algorithm, while shape, margin and echogenicity were excluded.…”

Section: Discussionmentioning

confidence: 85%

Differential diagnosis of thyroid nodules through a combination of multiple ultrasonography techniques: A decision‑tree model

et al. 2020

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The present study aimed to establish a decision tree (DT) model by combining the parameters of conventional gray-scale ultrasonography (US), elastosonography (ES), color Doppler US (CDUS) and contrast-enhanced US (CEUS) for the differential diagnosis of thyroid nodules. A single-center, retrospective study of 321 thyroid nodules was conducted. For 222 nodules, parameters of conventional gray-scale US, CDUS, ES and CEUS were evaluated using univariate logistic regression. Factors for with P<0.10 were further assessed using multivariate logistic regression. Significant factors (P<0.05) were used to establish a DT. The diagnostic accuracy of this DT was then evaluated by its application to the other 99 nodules. After univariate logistic analysis, factors including gender, number of nodules and diffuse disease were excluded, due to P>0.10. The results of multivariate logistic analysis determined that the following factors were required for the DT: Extent of blood flow determined by CDUS (P= 0.002), area ratio determined by ES (P= 0.033), peak phase patterns determined by CEUS (P<0.001) and micro-calcification determined by conventional gray-scale US (P=0.015). When compared to the pathological or cytological results of 99 nodules, the resulting DT had a sensitivity of 98.6%, specificity of 80.1%, positive predictive value of 93.5% and negative predictive value of 95.5%. These results suggested that a DT combining conventional gray-scale US, ES, CDUS and CEUS may be helpful for differentiating between types of thyroid nodules.

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Section: Discussionmentioning

confidence: 85%

Differential diagnosis of thyroid nodules through a combination of multiple ultrasonography techniques: A decision‑tree model

et al. 2020

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“…Several previous studies reported that US was more sensitive than CT for the detection of calcifications in thyroid nodules. 21,27 According to Lee et al, 33 US is superior to CT in the evaluation of microcalcifications. In addition, US combined with sonography-guided FNAC is a useful method for diagnosing thyroid microcalcifications.…”

Section: Discussionmentioning

confidence: 99%

“… 23 - 26 Therefore, calcification features in US or CT require further study. Several previous studies have shown that for detecting calcifications in thyroid nodules, US is superior to CT regardless of the calcification distribution pattern, 27 partly because the layer thickness and slice interval easily miss microcalcifications in CT. 28 We hypothesized that the presence or absence of calcification and calcification size affect the diagnostic accuracy of US and CT in predicting the benign or malignant nature of nodules.…”

Section: Introductionmentioning

confidence: 99%

Comparison of Ultrasonography and CT for Determining the Preoperative Benign or Malignant Nature of Thyroid Nodules: Diagnostic Performance According to Calcification

Jian-hui

Zeng

Renguo

et al. 2020

Technol Cancer Res Treat

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Background: The present study was designed to investigate the presence or absence of calcification and whether calcification size affect the diagnostic accuracy of ultrasonography (US) and computed tomography (CT) in predicting the benign or malignant nature of thyroid nodules. Material and Methods: From May 2014 to April 2019, 445 patients underwent thyroid US and neck CT before thyroid surgery. In each case, US and CT were retrospectively examined by radiologists. We divided the patients into 3 groups according to the type of calcification: no calcification, microcalcification, and macrocalcification. And macrocalcification group divided into rim calcifications and non-rim calcifications groups. We evaluated the diagnostic accuracy of US and CT for differentiating malignant from benign thyroid nodules using histopathological results as a reference standard. Results: In the overall population, adding CT to US resulted in greater sensitivity, lower specificity, and lower accuracy in the prediction of the benign or malignant nature of nodules. In the group with no calcification, US had a significantly greater accuracy than CT and combined US/CT. In the group with macrocalcification, especially in rim calcifications, adding CT to US resulted in greater sensitivity than US, and CT exhibited greater sensitivity and accuracy than US. Conclusion: US is superior to CT for the prediction of the benign or malignant nature of nodules in thyroid lesions according to calcification and CT is also currently not recommended as a routine imaging tool for thyroid nodules. However, the superior sensitivity and accuracy of CT in lesions with macrocalcification especially in rim calcifications may enable CT to play a complementary role in identifying benign and malignant nodules.

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“…Ultrasonography is more sensitive and reliable than other imaging, in diagnosis of calcification thyroid nodules [38] . Ultrasound is routinely used to assess thyroid gland and some sonographic features may help in diagnosis of benign and malignant nodules.…”

Section: A B Cmentioning

confidence: 99%

Accuracy of Ultrasonic Thyroid Nodules‘ Calcifications in Detection of Malignancy in Northern Iran

Alaee

Sakhaee

Akha

et al. 2018

International Journal of Radiology

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have a predictive value for malignancy of thyroid nodules. MATERIALS AND METHODS: In the diagnostic study, included 390 patients with thyroid nodules underwent ultrasound sonography. FNA(fine-needle aspiration biopsy)was performed on all 413 nodules, and the 97 cases with calcifications were separated from the study and matched to the type of pathology. Each echogenic particle with or without posterior shadow was considered calcification; those < 2 mm were considered microcalcification and those >2 mm macrocalcification. Other forms of calcification were also identified. RESULTS: A total of 413 nodules were examined, of which 97 cases had calcification, including 70 cases (73.7%) macrocalcification and 27 (26.3%) microcalcification. Pathology revealed 80 benign nodules (82.5%) and 17 malignant nodules (17.5%). There was a significant difference between macro-calcification and microcalcification pathologically, so that nodules with microcalcification had higher rates of malignancy than nodules with macrocalcification (p < 0.001). The Sensitivity and Specificity of microcalcification and macrocalcification were 65%, 80% and 35%, 35% respectively. But the difference between central and peripheral calcifications was not significant regarding malignancy (p = 0.07). CONCLUSION: Observation of microcalcification in the thyroid nodules is important and the probability of malignancy is higher in these nodules.

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Is Ultrasonography More Sensitive Than Computed Tomography for Identifying Calcifications in Thyroid Nodules?

Abstract: US is more sensitive and accurate than CT for detecting calcifications in thyroid nodules. Hence, US is recommended as the preferred imaging modality for calcification detection in thyroid nodules.

Cited by 7 publications

References 29 publications

Differential diagnosis of thyroid nodules through a combination of multiple ultrasonography techniques: A decision‑tree model

Differential diagnosis of thyroid nodules through a combination of multiple ultrasonography techniques: A decision‑tree model

Comparison of Ultrasonography and CT for Determining the Preoperative Benign or Malignant Nature of Thyroid Nodules: Diagnostic Performance According to Calcification

Accuracy of Ultrasonic Thyroid Nodules‘ Calcifications in Detection of Malignancy in Northern Iran

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