Preliminary Study on the Diagnostic Value of Acoustic Radiation Force Impulse Technology for Differentiating Between Benign and Malignant Thyroid Nodules

Gu, Jiying; Du, Lianfang; Bai, Mingwen; Chen, Huili; Jia, Xiaohong; Zhao, Jing; Zhang, Xuemei

doi:10.7863/jum.2012.31.5.763

Cited by 82 publications

(72 citation statements)

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“…In total, 77.6 % (59 of 76) of the benign nodules showed softer and equal images in the VTI mode, and 77.3 % (17 of 22) of the malignant nodules showed stiffer images (P \ 0.001). They concluded that ARFI imaging has high sensitivity and specificity in evaluating benign and malignant thyroid nodules and therefore a good diagnostic value in clinical applications [16]. More recently, Friedrich-Rust et al [14] compared ARFI and RTE to differentiate benign from malignant thyroid nodules.…”

Section: Discussionmentioning

confidence: 99%

“…Increased reliance on nodule stiffness quantification is therefore needed to bring about a standardization of diagnostic criteria. Acoustic radiation force impulse technology (ARFI), already used in different fields, has also been applied to evaluate diffuse thyroid diseases, [14,15], and recently to differentiate thyroid nodules such as in the study performed by Gu et al [16].…”

Section: Introductionmentioning

confidence: 99%

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Prospective evaluation of acoustic radiation force impulse technology in the differentiation of thyroid nodules: accuracy and interobserver variability assessment

et al. 2014

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Purpose The aim of this study is to assess the diagnostic efficacy and interobserver agreement of acoustic radiation force impulse (ARFI) elasticity imaging in differentiating thyroid nodules. Methods In our study, 74 consecutive patients (52 females, 22 males; age range 27-77 years, mean: 41 years) with 82 thyroid nodules (60 benign nodules, and 22 malignant) were examined by two radiologists with different experience. Patients underwent either cytology using fine needle aspiration cytology or thyroid surgery. The diagnostic performance of the two operators at ARFI with sensitivity, specificity, positive predictive and negative predictive value, and ROC curves was estimated. Interreader variability between the two operators was defined using Cohen's k.Results According to receiver operating characteristics ROC curves (AUROC = 0.86 for observer 1; 0.81 for observer 2) sensitivity, specificity, PPV and NPV of reader 1 and 2 were respectively: 90, 75, 90.91 and 96.55 %; (cutoff value of shear wave: 2.455 m/s); 90, 72, 90 and 96.90 % (cut-off value shear wave: 2.365 m/s). Concordance between the two operators was good (k = 0.755). Conclusions This work is a feasibility study evaluating ARFI imaging. Its results suggest that ARFI imaging is a reproducible method which can be utilized with good diagnostic performance in the thyroid for discriminating benign and malignant nodules using the cut-off value of 2.455 m/s. However, larger studies are needed to validate this method.Keywords Acoustic radiation force impulse (ARFI) Á Elastography Á Benign thyroid nodules Á Malignant thyroid nodules Á Ultrasound Riassunto Scopo Lo scopo di questo studio è la valutazione della efficacia diagnostica e della concordanza inter-osservatore dell'imaging elastografico ARFI, per la differenziazione di noduli tiroidei. Metodo Nel nostro studio, 74 pazienti consecutivi (52 femmine, 22 maschi; range di età 22-77 anni, età media 41 anni) con 82 noduli tiroidei (60 noduli benigni e 22 maligni), sono stati esaminati da due radiologi con diverso livello di esperienza. I pazienti sono stati sottoposti o a citologia aspirativa con ago sottile (FNAC), o a chirurgia tiroidea. La performance diagnostica dei due operatori all' ARFI è stata stimata con la sensibilità, la specificità, il valore predittivo positivo (VPP) e negativo (VPN), attraverso le curve ROC (receiver operating characteristics). La variabilità inter-osservatore tra i due operatori, è stata definita usando la kappa di Cohen. (2014( ) 17:13-20 DOI 10.1007 Risultati Secondo le curve ROC (AUROC = 0.86 per il primo osservatore; 0.81 per il secondo osservatore) la sensibilità, la specificità, il VPP e il VPN per gli osservatori 1 e 2, erano rispettivamente: 90, 75, 90,91, e 96.55 %; (valore medio di shear wave: 2.455 m/s); 90, 72, 90 e 96.90 % (valore medio di shear wave: 2.365 m/s). La concordanza tra I due operatori era buona (k = 0.755). Conclusioni Questo lavoro è uno studio preliminare che valuta l'imaging elastografico con Acustic Radiation Force Impulse. I risultati sug...

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Prospective evaluation of acoustic radiation force impulse technology in the differentiation of thyroid nodules: accuracy and interobserver variability assessment

et al. 2014

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“…A weak negative correlation calculated in SWE, "X.XX" is displayed on the monitor [10,11]. There are various interpretations of "X.XX" [5,10,[12][13][14][15], with a major view being that "X.XX" represents the SWVs that exceed the range of 1−10 m/s for SWE [5,10,12]. In their study, Bojunga et al substituted numerical values of 8.4 m/s, when "X.XX" was displayed on the monitor [5].…”

Section: Phantom Studymentioning

confidence: 99%

Phantom experiment and clinical utility of quantitative shear wave elastography for differentiating thyroid nodules

et al. 2014

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Recently ultRasonogRaphy equipment has remarkably improved. High-resolution ultrasonography excels in the detection of thyroid lesions, and it is an essential tool for diagnosing thyroid diseases. The present of specific features on B-mode sonography, evaluation of blood flow with Doppler sonography, and the strain ratio measured by strain elastography (SE) provide predictions of tissue characteristics to a certain degree. However, ultrasonography remains suboptimal for diagnosing thyroid diseases [1,2].The novel technology of shear wave elastography (SWE), also known as virtual touch quantification For phantom study, we measured the shear wave velocities (SWVs) of the four spheres of 2-and 1-cm diameters with varying hardness. For clinical study, the SWVs of normal thyroid glands and thyroid nodules, that were classified as benign or malignant according to either cytological or pathological findings, were measured. The SWVs of each thyroid patient were compared with that of a normal thyroid and each other. In phantom study, the SWVs for the 2-cm spheres correlated with the hardness of the targets, whereas the values for the 1-cm spheres did not. In clinical study, 112 nodules identified in 167 patients and 94 normal thyroid glands were analyzed according to the criteria for the study. The nodules included 84 benign nodules, and 28 papillary carcinoma. The mean SWVs of each group were 1.64 ± 0.47 m/s for normal thyroid, 1.88 ± 0.62 m/s for benign nodules and 2.67 ± 0.76 m/s for papillary carcinoma. The SWVs of papillary carcinoma were significantly higher than those of benign nodules (P < 0.001). The area under the ROC curve was 0.809 with a cutoff value of 2.01 m/s. The sensitivity and specificity were 85.7% and 62.0% respectively. Results showed that SWE provides new information on tumor characteristics, such as hardness and larger nodules tended to provide stable measurements.

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“…Кроме того, необходимы дополнительные исследова-ния для установления пороговых величин эластоме-трии, а также уточнение эластографических параме-тров диагностики субклинических метастазов. Пороговая величина для дифференциальной диагно-стики между непораженными и пораженными опухо-лью лимфатическими узлами, по данным различных исследований, колеблется в пределах 1,5-4,82 м / с [20,[24][25][26][27][28].…”

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Evaluation of capability of ultrasound with elastometry and elastography for diagnosis of subclinical regional metastases of cancer of the oral mucosa

Алымов¹

2017

Opuholi golovy šei

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Опухоли ГОЛОВЫ и ШЕИ HEAD and NECK tumors Том 7 Vol. 7 1 '2017 Диагностика и лечение опухолей головы и шеи 31Оценка возможностей ультразвукового исследования в режимах эластометрии и эластографии в диагностике субклинических регионарных метастазов рака слизистой оболочки полости рта Одним из основных инструментальных методов оценки состояния регионарных лимфатических узлов при раке полости рта является ультразвуковой метод исследования (УЗИ). Однако эффективность УЗИ в В-режиме и режимах эластографии и эластометрии в диа-гностике скрытых регионарных метастазов плоскоклеточного рака слизистой оболочки полости рта не изучена. Отсутствуют данные о пороговых величинах эластометрии, а также не уточнены эластографические параметры диагностики скрытых метастазов. Материалы и методы. В исследование включались первичные больные раком слизистой оболочки полости рта в стадии cT1-3N0M0. Диагноз плоскоклеточного рака был морфологически верифицирован. На первом этапе (амбулаторном) до включения в исследование выполнялась пальпация зон регионарного метастазирования, которая дополнялась УЗИ в В-режиме. При выявле-нии подозрения (на основании данных УЗИ) на метастаз в лимфатическом узле проводилась пункция последнего. При положи-тельном результате пункции пациент не включался в исследование. Затем в рамках клинического испытания было выполнено исследование 102 (82,3 %) пациентам в B-режиме и 22 (17,7 %) пациентам с использованием новых методик -эластометрии и эластографии. Результаты УЗИ сопоставлялись с данными гистологического исследования удаленной клетчатки шеи. Произ-водился расчет информативности УЗИ в В-режиме и в режимах эластометрии и эластографии.Результаты. УЗИ в В-режиме в диагностике скрытых метастазов характеризовалось чувствительностью (0 %), специфично-стью (88,2 %), точностью (80,4 %), эффективностью (44,1 %), прогностической ценностью положительного (0 %) и отрица-тельного (90,1 %) результата . Чувствительность метода УЗИ с использованием эластографии по выявлению субклинических метастазов составила 83,3 %, специфичность -100 %, точность -95,5 %, эффективность -91,7 %, прогностическая Злокачественные опухоли области головы и шеи характеризуются высокой частотой метастазирования в регионарные лимфатические узлы, которая варьиру-ет от 40 до 80 % [2]. При этом состояние лимфатиче-ских узлов шеи не только влияет на тактику лечения больных с опухолями головы и шеи, но и является наиболее значимым прогностическим фактором [3]. При реализованных регионарных метастазах рака сли-зистой оболочки полости рта отмечается двукратное снижение пятилетней выживаемости [4,5].Таким образом, оценка путей регионарного лим-фатического оттока при раке слизистой оболочки по-лости рта играет важную роль не только в определении прогноза заболевания, но и в выборе тактики лечения.Одним из основных инструментальных методов оценки состояния регионарных лимфатических узлов при раке полости рта является ультразвуковой метод исследования (УЗИ) ввиду его общедоступности, без-опасности, отсутствия больших экономических и вре-менных затрат...

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Preliminary Study on the Diagnostic Value of Acoustic Radiation Force Impulse Technology for Differentiating Between Benign and Malignant Thyroid Nodules

Cited by 82 publications

References 27 publications

Prospective evaluation of acoustic radiation force impulse technology in the differentiation of thyroid nodules: accuracy and interobserver variability assessment

Prospective evaluation of acoustic radiation force impulse technology in the differentiation of thyroid nodules: accuracy and interobserver variability assessment

Phantom experiment and clinical utility of quantitative shear wave elastography for differentiating thyroid nodules

Evaluation of capability of ultrasound with elastometry and elastography for diagnosis of subclinical regional metastases of cancer of the oral mucosa

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