Value of Contrast-Enhanced Ultrasound and Acoustic Radiation Force Impulse Imaging for the Differential Diagnosis of Benign and Malignant Thyroid Nodules

He, Yan; Wang, Xiao Yan; Qiao, Hui; Chen, Xue Xue; Ling, Bing; Wei, Hai Ming

doi:10.3389/fphar.2018.01363

Cited by 18 publications

(13 citation statements)

References 27 publications

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“…Five indicators were analyzed: arrival time, mode of entrance, echo intensity, homogeneity, and washout time. Within the subgroup of <10 mm there was a statistically significant difference between benign and malignant thyroid nodules for arrival time, mode of entrance and washout time; however, all five [30] indicators showed a statistically significant difference within the subgroup of >10 mm and the total group. The specificity for previously mentioned indicators ranged from 90-96% and diagnostic accuracy between 75-82%.…”

Section: Qualitative Analysis Of Ceus Enhancement Patternsmentioning

confidence: 74%

“…The most prominent features of nodules pointing to malignancy on CEUS were low enhancement and rim-like enhancement [58]. In contrast, other authors reported rim-enhancement as a pattern for benign nodules [30].…”

Section: Qualitative Analysis Of Ceus Enhancement Patternsmentioning

confidence: 90%

“…A typical protocol for thyroid nodules CEUS examination includes low mechanical index (MI < 0.10) and the focus zone should be placed at the lower portion of the FOV [29] preferably including the entire nodule and surrounding thyroid tissue in the longitudinal plane. When the conventional B-mode image is properly adjusted and the CEUS mode activated, a microbubble contrast agent is injected as an intravenous bolus, generally with a dose of around 1.0-2.0 mL, followed by 5-10 mL of saline; however, specific amounts of CA and saline vary between operators and institutions [30][31][32][33]. A CEUS timer is started simultaneously with the injection of the contrast agent, and cine-clips of the scanning are stored digitally as raw data for 2-3 min before being processed, but the length of examination differs between sources and institutions, with most authors choosing a time period of at least 2 min [34,35].…”

Section: The Technique Of Contrast-enhanced Ultrasound In Thyroid Imagingmentioning

confidence: 99%

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Performance of Contrast-Enhanced Ultrasound in Thyroid Nodules: Review of Current State and Future Perspectives

Radziņa

Ratniece

Putriņš

et al. 2021

Cancers

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Ultrasound has been established as a baseline imaging technique for thyroid nodules. The main advantage of adding CEUS is the ability to assess the sequence and intensity of vascular perfusion and hemodynamics in the thyroid nodule, thus providing real-time characterization of nodule features, considered a valuable new approach in the determination of benign vs. malignant nodules. Original studies, reviews and six meta-analyses were included in this article. A total of 624 studies were retrieved, and 107 were included in the study. As recognized for thyroid nodule malignancy risk stratification by US, for acceptable accuracy in malignancy a combination of several CEUS parameters should be applied: hypo-enhancement, heterogeneous, peripheral irregular enhancement in combination with internal enhancement patterns, and slow wash-in and wash-out curve lower than in normal thyroid tissue. In contrast, homogeneous, intense enhancement with smooth rim enhancement and “fast-in and slow-out” are indicative of the benignity of the thyroid nodule. Even though overlapping features require standardization, with further research, CEUS may achieve reliable performance in detecting or excluding thyroid cancer. It can also play an operative role in guiding ablation procedures of benign and malignant thyroid nodules and metastatic lymph nodes, and providing accurate follow-up imaging to assess treatment efficacy.

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Section: Qualitative Analysis Of Ceus Enhancement Patternsmentioning

confidence: 74%

Section: Qualitative Analysis Of Ceus Enhancement Patternsmentioning

confidence: 90%

Section: The Technique Of Contrast-enhanced Ultrasound In Thyroid Imagingmentioning

confidence: 99%

See 1 more Smart Citation

Performance of Contrast-Enhanced Ultrasound in Thyroid Nodules: Review of Current State and Future Perspectives

Radziņa

Ratniece

Putriņš

et al. 2021

Cancers

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“…For CEUS, according to previous articles 21,25 and our clinical experience, thyroid nodules were evaluated with the following characteristics: homogeneity of enhancement, classified as homogeneous or heterogeneous; enhanced intensity (with respect to the surrounding normal thyroid parenchyma) was classified as hyper-enhancement, iso-enhancement or hypo-enhancement; ring enhancement (hyperechoic rim in the periphery of a nodule at the peak intensity), was classified as present (regular and complete) or absent (no, irregular or incomplete); enhanced border (the boundary between the nodule and the surrounding parenchyma at the peak intensity), was classified as welldefined or ill-defined; extrathyroidal extension (the thyroid nodule's enhancement range contacted/discontinued the hyperechoic thyroid capsule or extended out of the thyroid capsule) 26 was classified as no or yes (Figures 1C and 2C); centripetal enhancement (the contrast agent enters the nodule from the periphery of the nodule to the center), was classified as yes or no; the relative time of wash-in (using the surrounding normal thyroid parenchyma as a reference), was classified as earlier, concurrent, or later; and the relative time of wash-out time (using the surrounding normal thyroid parenchyma as a reference), was classified as earlier, concurrent, or later.…”

Section: Contrast-enhanced Ultrasoundmentioning

confidence: 99%

Value of Combining Clinical Factors, Conventional Ultrasound, and Contrast-Enhanced Ultrasound Features in Preoperative Prediction of Central Lymph Node Metastases of Different Sized Papillary Thyroid Carcinomas

Wang

Nie

Wang

et al. 2021

CMAR

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Purpose Early and accurate preoperative diagnosis of central lymph node metastasis (CLNM) is crucial to improve surgical management of patients with clinical lymph node-negative papillary thyroid carcinoma (PTC). Towards improving diagnosis of CLNM, we assessed the value of combining preoperative clinical characteristics, conventional ultrasound, and contrast-enhanced ultrasound (CEUS) in preoperative prediction of CLNM of different sized PTCs. Patients and Methods Patients were divided according to tumor size: a PTC group (>10 mm) and a papillary thyroid microcarcinoma (PTMC) group (≤10 mm). We retrospectively analyzed the clinical and ultrasonographic features of 120 PTC patients and 165 PTMC patients. Multivariate logistic regression analysis was used to screen independent risk factors and establish prediction models. Receiver operating characteristic curves were used to determine the best cut-off values for continuous variables and assess the performance of prediction models. Results Independent risk predictors of CLNM for the PTC group were extrathyroidal extension in CEUS (OR=7.923), tumor size >14 mm (OR=5.491), and multifocality (OR=3.235). For the PTMC group, the independent risk factors were the distance from the thyroid capsule =0 mm (OR=4.629), male (OR=3.315), tumor size >5 mm (OR=3.304), and microcalcification (OR=2.560). The predictive model of combined method had better performance in predicting CLNM of PTC compared with models based on CEUS and conventional ultrasound alone (area under the curve: 0.832 vs 0.739, P =0.0011; 0.832 vs 0.678, P =0.0012). For PTMC, comparing with CEUS, the combined method and conventional ultrasound performed better than CEUS alone in predicting CLNM (area under the curve: 0.783 vs 0.636, P =0.0016; 0.738 vs 0.636, P =0.0196). Conclusion The predictive models of combined method obtained from significant preoperative clinical and ultrasonographic features can potentially improve the preoperative diagnosis and individual treatment of CLNM in patients with PTC and PTMC. CEUS may be helpful in predicting CLNM of PTC, but CEUS would be ineffective in predicting CLNM of PTMC.

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“…For example, contrast-enhanced US (CEUS) employs a microbubble agent to enhance the backscatter signals of red blood cells and can be used to characterize local vascular perfusion. Several studies have explored the perfusion patterns of thyroid nodules using CEUS (12)(13)(14). Elastosonography (ES) can be used to estimate malignancy by assessing the hardness of tissues (15).…”

Section: Introductionmentioning

confidence: 99%

Differential diagnosis of thyroid nodules through a combination of multiple ultrasonography techniques: A decision‑tree model

et al. 2020

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The present study aimed to establish a decision tree (DT) model by combining the parameters of conventional gray-scale ultrasonography (US), elastosonography (ES), color Doppler US (CDUS) and contrast-enhanced US (CEUS) for the differential diagnosis of thyroid nodules. A single-center, retrospective study of 321 thyroid nodules was conducted. For 222 nodules, parameters of conventional gray-scale US, CDUS, ES and CEUS were evaluated using univariate logistic regression. Factors for with P<0.10 were further assessed using multivariate logistic regression. Significant factors (P<0.05) were used to establish a DT. The diagnostic accuracy of this DT was then evaluated by its application to the other 99 nodules. After univariate logistic analysis, factors including gender, number of nodules and diffuse disease were excluded, due to P>0.10. The results of multivariate logistic analysis determined that the following factors were required for the DT: Extent of blood flow determined by CDUS (P= 0.002), area ratio determined by ES (P= 0.033), peak phase patterns determined by CEUS (P<0.001) and micro-calcification determined by conventional gray-scale US (P=0.015). When compared to the pathological or cytological results of 99 nodules, the resulting DT had a sensitivity of 98.6%, specificity of 80.1%, positive predictive value of 93.5% and negative predictive value of 95.5%. These results suggested that a DT combining conventional gray-scale US, ES, CDUS and CEUS may be helpful for differentiating between types of thyroid nodules.

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Value of Contrast-Enhanced Ultrasound and Acoustic Radiation Force Impulse Imaging for the Differential Diagnosis of Benign and Malignant Thyroid Nodules

Cited by 18 publications

References 27 publications

Performance of Contrast-Enhanced Ultrasound in Thyroid Nodules: Review of Current State and Future Perspectives

Performance of Contrast-Enhanced Ultrasound in Thyroid Nodules: Review of Current State and Future Perspectives

Value of Combining Clinical Factors, Conventional Ultrasound, and Contrast-Enhanced Ultrasound Features in Preoperative Prediction of Central Lymph Node Metastases of Different Sized Papillary Thyroid Carcinomas

Differential diagnosis of thyroid nodules through a combination of multiple ultrasonography techniques: A decision‑tree model

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