Superb microvascular imaging (SMI) compared with conventional ultrasound for evaluating thyroid nodules

Lu, Ran; Meng, Weizhi; Zhang, Yan; Zhao, Wei; Wang, Xun; Jin, Mulan; Guo, Renhua

doi:10.1186/s12880-017-0241-5

Cited by 80 publications

(74 citation statements)

References 14 publications

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“…15 Superb Microvascular Imaging provides useful information for both qualitative and quantitative analysis compared with PDUS. [16][17][18][19] It has both color and monochromatic modes of vascular imaging. The color mode displays B-mode and color information simultaneously and facilitates a time-smoothing function control, which results in accurate visualization of vessel continuity.…”

Section: Vascular Pattern Analysis Using Power Doppler Ultrasound (Pdmentioning

confidence: 99%

“…The unique algorithm separates flow signals from motion artifacts and clutter and consequently enables visualization of very low‐velocity microvascular flow in LNs that is not usually attainable with PDUS . Superb Microvascular Imaging provides useful information for both qualitative and quantitative analysis compared with PDUS . It has both color and monochromatic modes of vascular imaging.…”

mentioning

confidence: 99%

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Differentiation Between Malignant and Benign Lymph Nodes: Role of Superb Microvascular Imaging in the Evaluation of Cervical Lymph Nodes

Sim

Lee

Hong

2019

J of Ultrasound Medicine

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Objectives This study aimed to assess the value of Superb Microvascular Imaging (SMI; Canon Medical Systems, Otawara, Japan) for distinguishing between benign and malignant cervical lymph nodes (LNs) and to compare SMI with power Doppler ultrasound (PDUS). Methods Power Doppler ultrasound and SMI examinations were performed for patients’ cervical LNs. The distribution of feeding vessels, number, and appearance of internal vessels were analyzed by 2 readers, and the results of PDUS and SMI were compared. Interobserver agreement was assessed. A subgroup analysis was performed to assess differences in vascular patterns between metastasis and tuberculous lymphadenitis and between Kikuchi disease and lymphoma. The diagnostic performance for distinguishing between benign and malignant LNs was calculated. Results In total, 147 patients with 147 cervical LNs (85 benign and 62 malignant) were assessed. Interobserver agreement was moderate to strong for SMI. There were significant differences in the vascular patterns between benign and malignant LNs on SMI (distribution, number, and appearance, all P < .001), but not on PDUS. In the subgroup analysis, SMI showed a significant difference in the vascular patterns observed between metastasis and tuberculous lymphadenitis (distribution, P = .012; number, P = .014; and appearance, P = .005). Superb Microvascular Imaging detected significantly greater numbers of vessels in lymphoma than in Kikuchi disease (P = .012). The sensitivity of SMI was significantly greater than that of PDUS in distinguishing malignant from benign LNs (86.9% versus 54.1%; P < .001). Conclusions Superb Microvascular Imaging yields more detailed information about nodal vessels than does PDUS by enabling visualization of small nodal vessels. Superb Microvascular Imaging is useful and feasible for differentiating between malignant and benign cervical LNs.

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Section: Vascular Pattern Analysis Using Power Doppler Ultrasound (Pdmentioning

confidence: 99%

mentioning

confidence: 99%

Differentiation Between Malignant and Benign Lymph Nodes: Role of Superb Microvascular Imaging in the Evaluation of Cervical Lymph Nodes

Sim

Lee

Hong

2019

J of Ultrasound Medicine

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“…Assessment of thyroid malignancy based on intranodular and peripheral vascularity detected using Doppler ultrasound has been attempted by several researchers [2][3][4][5][6][7][8][9][10][11] . However, large tissue motion in unavoidable in thyroid imaging due to its proximity to the pulsating carotid artery -a major challenge in reliably imaging small vessel blood flow.…”

mentioning

confidence: 99%

Impact of imaging cross-section on visualization of thyroid microvessels using ultrasound: Pilot study

Nayak¹,

Nawar²,

Webb³

et al. 2020

Sci Rep

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Non-invasive, contrast-free microvascular imaging of human thyroids can be potentially beneficial in reducing the large number of benign biopsies of suspicious nodules. However, motion incurred by thyroid due to its proximity to the pulsating carotid artery significantly impacts the visualization of blood flow in small vessels. Singular value based spatiotemporal clutter filtering (SVD-STF) improves the performance of tissue rejection in the presence of motion. However, despite effective clutter filtering, motion in thyroid imaging can impact coherent integration of the Doppler ensemble and degrade the visualization of the underlying vasculature. Recently studies have demonstrated that motion correction using 2D normalized cross-correlation based speckle tracking can address this issue, however, only in-plane motion can be tracked and corrected. Given the natural anatomical orientation of the rigid trachea, thyroid and the pulsating carotid artery, we hypothesize that imaging of thyroid microvessels may be more reliable in the longitudinal view than in the transverse. Specifically, distal presence of rigid trachea can limit out-of-plane motion in the longitudinal view. We tested this hypothesis on 48 acquisitions obtained from 24 thyroid patients having at least one suspicious nodule. In each patient, ultrasound images of the thyroid were acquired in both longitudinal and transverse views. compounded plane-wave imaging was used to acquire the ultrasound images at high frame-rate, which is important for contrast-free small vessel blood flow imaging. Thyroid motion was tracked using 2D normalized cross-correlation based speckle tracking. tissue clutter was rejected using singular value decomposition based spatiotemporal clutter filtering. The clutter-filtered Doppler ensemble was motion corrected prior to slow-time power Doppler integration. Signal-to-noise and contrast-to-noise ratios were computed to assess the improvement in quality of the power Doppler images. Out-of-plane motion was detected by estimating normalized ensemble cross-correlation coefficient. The results demonstrated that motion associated with the thyroid due to the carotid artery was primarily in the lateral direction, which could be estimated and corrected using 2D speckle tracking. However, the motion in the transverse view displayed increased speckle decorrelation. The average ensemble cross-correlation coefficient of the thyroid ultrasound images were significantly higher (p < 0.05) in the longitudinal view than in the transverse view. The largest improvement in SNR and CNR of the estimated PD images upon motion correction was observed in the longitudinal view (12.95 ± 3.76 dB and 16.48 ± 4.6 dB) than in the transverse view (3.72 ± 0.894 dB and 6.217 ± 1.689 dB). These preliminary results show that motion encountered by the thyroid due to carotid pulsations can be effectively tracked and corrected in the longitudinal view relative to transverse, which is important for reliably visualizing the underlying blood flow. Non-invasive microvascular...

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“…35 A further study compared SMI with CDFI and CEUS for depicting microvascular flow in thyroid nodules and found that the accuracies of conventional US combined with CDFI, SMI, and CEUS for predicting malignancy were 67.31%, 86.54%, and 92.31%, respectively. The accuracy of SMI differed significantly from the accuracy of CDFI but not CEUS, 36 indicating that SMI may be a more economical method of depicting the microvasculature in thyroid nodules. Using SMI can prevent adverse reactions associated with the contrast agents used in CEUS, although the frequency of these reactions is relatively low.…”

Section: Superb Microvascular Imaging For Evaluating Thyroid Nodulesmentioning

confidence: 82%

Clinical Applications of Superb Microvascular Imaging in the Liver, Breast, Thyroid, Skeletal Muscle, and Carotid Plaques

Jiang

Huang

Shen

et al. 2019

J of Ultrasound Medicine

103

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This article reviews the clinical applications of Superb Microvascular Imaging (SMI; Canon Medical Systems, Otawara, Japan) in the liver, breast, thyroid, skeletal muscle, and carotid plaques. Diseases that are closely associated with angiogenesis can be diagnosed by SMI in a relatively early phase, and using SMI can prevent adverse reactions associated with the contrast agents used in contrast‐enhanced ultrasound. Super Microvascular Imaging also shows particular value in grading disease activities and monitoring therapeutic responses. Although SMI has some limitations, such as a lack of clinical standards, it can add information to conventional ultrasound examinations and may become a noninvasive alternative to invasive diagnostic procedures for many clinical conditions.

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Superb microvascular imaging (SMI) compared with conventional ultrasound for evaluating thyroid nodules

Cited by 80 publications

References 14 publications

Differentiation Between Malignant and Benign Lymph Nodes: Role of Superb Microvascular Imaging in the Evaluation of Cervical Lymph Nodes

Differentiation Between Malignant and Benign Lymph Nodes: Role of Superb Microvascular Imaging in the Evaluation of Cervical Lymph Nodes

Impact of imaging cross-section on visualization of thyroid microvessels using ultrasound: Pilot study

Clinical Applications of Superb Microvascular Imaging in the Liver, Breast, Thyroid, Skeletal Muscle, and Carotid Plaques

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