Systematic review and meta-analysis: diagnostic value of different ultrasound for benign and malignant thyroid nodules

Wang, Yin; Zhou, Chuangbing; Shen, Bo; Zeng, Zhuohua; Wang, Xinyu; Liu, Jiakai

doi:10.21037/gs-22-254

Cited by 5 publications

(6 citation statements)

References 43 publications

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“…In our study group, the presence of the ring-enhancement feature was reported in 16.9% of benign lesions compared to 4.1% of thyroid carcinomas (p = 0.006), while univariate and multivariate logistic regression models did not distinguish this feature as significantly excluding the malignant nature of the lesion. Remaining in the group of benign lesions, the authors of the current study showed that the features of high enhancement and homogenous enhancement allow a significant differentiation of these lesions from thyroid carcinomas, which was also confirmed in numerous studies carried out with a larger number of patients [38].…”

Section: The Utility Of Ceus Patterns Assessed In the Study In Line W...supporting

confidence: 82%

The Utility of Contrast-Enhanced Ultrasound (CEUS) in Assessing the Risk of Malignancy in Thyroid Nodules

Żyłka,

Dobruch-Sobczak,

Piotrzkowska-Wróblewska

et al. 2024

Cancers

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Background: Ultrasonography is a primary method used in the evaluation of thyroid nodules, but no single feature of this method predicts malignancy with high accuracy. Therefore, this paper aims to assess the utility of contrast-enhanced ultrasound (CEUS) in the differential diagnosis of thyroid nodules. Methods: The study group comprised 188 adult patients (155 women and 33 men) who preoperatively underwent CEUS of a thyroid nodule classified as Bethesda categories II–VI after fine-needle aspiration biopsy. During the CEUS examination, 1.5 mL of SonoVue contrast was injected intravenously, after which 15 qualitative CEUS enhancement patterns were analysed. Results: The histopathologic results comprised 65 benign thyroid nodules and 123 thyroid carcinomas. The dominant malignant CEUS features, such as hypo- and heterogeneous enhancement and slow wash-in phase, were evaluated, whereas high enhancement, ring enhancement, and a slow wash-out phase were assessed as predictors of benign lesions. Two significant combinations of B-mode and CEUS patterns were noted, namely, hypoechogenicity with heterogeneous enhancement and non-smooth margins with hypo- or iso-enhancement. Conclusions: The preliminary results indicate that CEUS is a useful tool in assessing the risk of malignancy of thyroid lesions. The combination of the qualitative enhancement parameters and B-mode sonographic features significantly increases the method’s usefulness.

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Section: The Utility Of Ceus Patterns Assessed In the Study In Line W...supporting

confidence: 82%

The Utility of Contrast-Enhanced Ultrasound (CEUS) in Assessing the Risk of Malignancy in Thyroid Nodules

Żyłka,

Dobruch-Sobczak,

Piotrzkowska-Wróblewska

et al. 2024

Cancers

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“…The pathological basis may be related to the malignant nodules’ complex neovascularization. Once the tumor grows beyond the newly formed vasculature, necrosis and embolism may occur in the tumor, resulting in an uneven enhancement or low enhancement pattern ( 5 , 12 , 32 ). Combining CEUS and quantitative analysis, our results also showed that malignant thyroid nodules tend to have low enhancement or uneven enhancement but without statistical difference.…”

Section: Discussionmentioning

confidence: 99%

Ultrasound super-resolution imaging for the differential diagnosis of thyroid nodules: A pilot study

Zhang

Lei

et al. 2022

Front. Oncol.

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ObjectiveUltrasound imaging provides a fast and safe examination of thyroid nodules. Recently, the introduction of super-resolution imaging technique shows the capability of breaking the Ultrasound diffraction limit in imaging the micro-vessels. The aim of this study was to evaluate its feasibility and value for the differentiation of thyroid nodules.MethodsIn this study, B-mode, contrast-enhanced ultrasound, and color Doppler flow imaging examinations were performed on thyroid nodules in 24 patients. Super-resolution imaging was performed to visualize the microvasculature with finer details. Microvascular flow rate (MFR) and micro-vessel density (MVD) within thyroid nodules were computed. The MFR and MVD were used to differentiate the benign and malignant thyroid nodules with pathological results as a gold standard.ResultsSuper-resolution imaging (SRI) technique can be successfully applied on human thyroid nodules to visualize the microvasculature with finer details and obtain the useful clinical information MVD and MFR to help differential diagnosis. The results suggested that the mean value of the MFR within benign thyroid nodule was 16.76 ± 6.82 mm/s whereas that within malignant thyroid was 9.86 ± 4.54 mm/s. The mean value of the MVD within benign thyroid was 0.78 while the value for malignant thyroid region was 0.59. MFR and MVD within the benign thyroid nodules were significantly higher than those within the malignant thyroid nodules respectively (p < 0.01).ConclusionsThis study demonstrates the feasibility of ultrasound super-resolution imaging to show micro-vessels of human thyroid nodules via a clinical ultrasound platform. The important imaging markers, such as MVD and MFR, can be derived from SRI to provide more useful clinical information. It has the potential to be a new tool for aiding differential diagnosis of thyroid nodules.

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“…[ 56 ] In a recent meta-analysis, the sensitivity of CEUS was found slightly higher than that of conventional US in distinguishing between benign and malignant nodules (0.87; [95% CI: 0.82–0.90] vs. 0.84 [95% CI: 0.75–0.90]). [ 57 ] The perfusion type of CEUS has good diagnostic performance for cervical lymph node metastasis in PTC. [ 58 ]…”

Section: Imaging Methodsmentioning

confidence: 99%

Management of Thyroid Nodules

Uludag

2023

Sisli Etfal

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Thyroid nodules are common and the prevalence varies between 4 and 7% by palpation and 19–68% by high-resolution USG. Most thyroid nodules are benign, and the malignancy rate varies between 7 and 15% of patients. Thyroid nodules are detected incidentally during clinical examination or, more often, during imaging studies performed for another reason. All detected thyroid nodules should be evaluated clinically. The main test in evaluating thyroid function is thyroid stimulating hormone (TSH). If the serum TSH level is below the normal reference range, a radionuclide thyroid scan should be performed to determine whether the nodule is hyperfunctioning. If the serum TSH level is normal or high, ultrasonography (US) should be performed to evaluate the nodule. US is the most sensitive imaging method in the evaluation of thyroid nodules. Computed tomography (CT) and magnetic resonance imaging are not routinely used in the initial evaluation of thyroid nodules. There are many risk classification systems according to the USG characteristics of thyroid nodules, and the most widely used in clinical practice are the American Thyroid Association guideline and the American College of Radiology Thyroid Imaging Reporting and Data System. Fine needle aspiration biopsy (FNAB) is the gold standard method in the evaluation of nodules with indication according to USG risk class. In the cytological evaluation of FNAB, the Bethesda System for Reporting Thyroid Cytopathology (TBSRTC) is the most frequently applied cytological classification. TBSRTC is a simplified, 6-category reporting system and was updated in 2023. The application of molecular tests to FNAB specimens, especially those diagnosed with Bethesda III and IV, is increasing to reduce the need for diagnostic surgery. Especially in Bethesda III and IV nodules, different methods are applied in the treatment of nodules according to the malignancy risk of each category, these are follow-up, surgical treatment, radioactive iodine treatment, and non-surgical ablation methods.

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Systematic review and meta-analysis: diagnostic value of different ultrasound for benign and malignant thyroid nodules

Abstract: Background: Conventional ultrasound and contrast-enhanced ultrasound (CEUS) are commonly used in the diagnosis of benign and malignant thyroid nodules. However, the value of the two methods in the diagnosis of benign and malignant thyroid nodules remains controversial.

Cited by 5 publications

References 43 publications

The Utility of Contrast-Enhanced Ultrasound (CEUS) in Assessing the Risk of Malignancy in Thyroid Nodules

The Utility of Contrast-Enhanced Ultrasound (CEUS) in Assessing the Risk of Malignancy in Thyroid Nodules

Ultrasound super-resolution imaging for the differential diagnosis of thyroid nodules: A pilot study

Management of Thyroid Nodules

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