Utility and Interobserver Agreement of Ultrasound Elastography in the Detection of Malignant Thyroid Nodules in Clinical Care

Merino, Salome; Arrazola, Juan; Cárdenas, A.; Mendoza, Michelle; Miguel, P. De; Fernández, Castro; Ganado, Tomás

doi:10.3174/ajnr.a2716

Cited by 51 publications

(26 citation statements)

References 31 publications

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“…In addition, we tested the interobserver variability as well. We obtained good results, with a Cohen's k value of 0.755, which is consistent with the result of the study of Lim et al [22] (k = 0.77) and Merino et al [31] (k = 0.82) using different elastographic techniques.…”

Section: Discussionsupporting

confidence: 91%

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: Discussionsupporting

confidence: 91%

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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“…However, later studies using the four score scale reported little interobserver variability [46], with almost perfect interobserver agreement [17], better for RTE than for the TIRADS score [6]. Excellent interobserver agreement was also reported using a three score gray scale system [55]. Although most studies state that using the quality indicator while performing RTE aims to reduce variability, little is known about the actual figures for intraobserver variability of scoring, although at least one study reported acceptable intraobserver reproducibility [61].…”

Section: Figmentioning

confidence: 98%

“…Even the early reports noted that follicular carcinoma may appear elastic on RTE [27]. Today it is well documented that RTE is not useful in diagnosing this type of carcinoma [4,21,42,43,55] as it may produce up to 44% false negative results [9]. Medullary, nondifferentiated and metastatic carcinoma may also appear elastic [4,21].…”

Section: What Is the Influence Of The Nodule Size On The Diagnosis?mentioning

confidence: 99%

Ultrasound elastography in thyroid disease

Dudea

Botar-Jid

2015

Med Ultrason

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Thyroid elastography has become, lately, one of the main focuses in thyroid imaging. With more than one hundred papers published on this subject, the core of accumulated knowledge justifies the need for a comprehensive review on the topic. The paper presents the various elastographic techniques used for thyroid assessment. Both strain and shear wave elastography, with all their variants, are discussed. Thereafter the paper proceeds to a detailed description of the technical peculiarities, diagnostic value, limitations and pitfalls for each technique. Although the main accent is placed on thyroid nodules, the applications of elastography in other thyroid disease, diffuse or focal, are also presented. The results of the available metaanalyses are reviewed and the proven value of the technique is highlighted. Still unanswered questions and directions for future research are emphasized, whenever appropriate.

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“…However, with the development of elastographic methods (for examples the ones used for the assessment of thyroid nodules), interobserver variability proved to no longer be a drawback. Furthermore, the association of US examination with elastography has proven extremely useful for a better characterization of thyroid nodules [46][47][48]. Regarding endorectal elastography, there are still not enough studies to make firm statements.…”

Section: Gray Scale Us (2d 3d)mentioning

confidence: 99%

Endoscopic ultrasound for the characterization and staging of rectal cancer. Current state of the method. Technological advances and perspectives.

et al. 2015

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Endoscopic ultrasound is the most accurate type of examination for the assessment of rectal tumors. Over the years, the method has advanced from gray-scale examination to intravenous contrast media administration and to different types of elastography. The multimodal approach of tumors (transrectal, transvaginal) is adapted to each case. 3D ultrasound is useful for spatial representation and precise measurement of tumor formations, using CT/MR image reconstruction; color elastography is useful for tumor characterization and staging; endoscopic ultrasound using intravenous contrast agents can help study the amount of contrast agent targeted at the level of the tumor formations and contrast wash-in/wash-out time, based on the curves displayed on the device. The transvaginal approach often allows better visualization of the tumor than the transrectal approach. Performing the procedure with the rectal ampulla distended with contrast agent may be seen as an optimization of the examination methodology. All these aspects are additional methods for gray-scale endoscopic ultrasound, capable of increasing diagnostic accuracy. This paper aims at reviewing the progress of transrectal and transvaginal ultrasound, generically called endoscopic ultrasound, for rectal tumor diagnosis and staging, with emphasis on the current state of the method and its development trends.

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Utility and Interobserver Agreement of Ultrasound Elastography in the Detection of Malignant Thyroid Nodules in Clinical Care

Cited by 51 publications

References 31 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

Ultrasound elastography in thyroid disease

Endoscopic ultrasound for the characterization and staging of rectal cancer. Current state of the method. Technological advances and perspectives.

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