New Proposed Formula of TI-RADS Classification Based on Ultrasound Findings

Karizaki, S Rahemi; Alamdaran, Seyed Ali; Bonakdaran, Shokoufeh; Morovatdar, Negar; Jafarain, A H; Hadad, A; Hadadzade, A

doi:10.4183/aeb.2020.199

Cited by 1 publication

(3 citation statements)

References 34 publications

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“…The basis for classification according to TI-RADS remains high-resolution B-scan sonography and, in addition, color Doppler [5][6][7]. Elastography and contrast medium sonography (CEUS) are also increasingly used [4,12,13,15].…”

Section: Discussionmentioning

confidence: 99%

“…If the results of the elastography measurements are also taken into account with regard to the possible tissue compaction of the tumors, additional criteria for malignancy can be obtained at high values. CEUS is helpful if wash out kinetics is to reveal the possible malignancy of individual foci in struma multinodosa [4][5][6][7][8][9][10][11][12][13][14][15][16]. Adenomas may show a central wash out in parts with persistent marginal vascularization.…”

Section: Discussionmentioning

confidence: 99%

“…Due to increasingly improving ultrasound technology with high-resolution multifrequency probes, cystic as well as complicated cystic lesions and tumor foci can be assessed with modern ultrasound even at small sizes of less than 1 cm in diameter [1][2][3][4][5][6]. Initial artificial intelligence (AI) approaches are being used to attempt to detect suspicious thyroid foci, size them, and digitally document criteria for classification according to TI-RADS in a standardized manner [7][8][9][10].…”

Section: Introductionmentioning

confidence: 99%

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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

Jung

Stroszczynski

Jung

2023

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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.

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