Vascularisation of Benign and Malignant Thyroid Nodules: CD US Evaluation

Ivanac, Gordana; Brkljačić, Boris; Ivanac, Krešo; Huzjan, Renata; Škreb, Franjo; Čikara, Igor

doi:10.1055/s-2007-963023

Cited by 44 publications

(38 citation statements)

References 8 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Regarding CDUS findings, some vascular patterns were classified to differentiate benign and malignant nodules. In previous studies, many authors have shown the association between the increased intranodular blood flow and malignancy [3,9,19,22,23]. According to the data of the current study, increased intranodular blood flow (Type IV) was a statistically significant criterion to suggest malignancy (p=0.001).…”

Section: Discussionsupporting

confidence: 50%

“…Consequently, a non-invasive, safe, and low cost diagnostic procedure is required, with high accuracy, to discriminate malignant and benign thyroid nodules. Several gray-scale US and color Doppler ultrasonography (CDUS) features have been reported to be highly suggestive of malignancy such as hypoechogenicity, presence of microcalcification, irregular contour, hypervascular central flow, and high Resistive Index (RI) (3,8,9). On the contrary, several authors claim that there are no correlations with the central flow, echogenicity, shape, and malignancy (9,11).…”

mentioning

confidence: 85%

“…In addition to vascular patterns, there are several studies that have shown the relationship with the histology of the thyroid nodules and vascular resistance [3,5,13,19,26]. RI is a good spectral Doppler parameter for evaluating thyroid nodules because it is not dependent on the angle of insonation.…”

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Ultrasonographic and color doppler ultrasonographic parameters to discriminate thyroid nodules

ÇORUH¹,

AKKAYA²,

ÖZTUNA³

et al. 2016

Ankara Üniversitesi Tıp Fakültesi Mecmuası

View full text Add to dashboard Cite

Objective: To determine parameters that can be used to predict malignant thyroid nodules by using grayscale ultrasonography and color Doppler ultrasonography Materials-methods: Gray-scale ultrasonography and color Doppler ultrasonography findings were retrospectively analyzed in 60 nodules with known histopathology. Of 60 nodules, 12 nodules were malignant. The evaluation criteria for gray-scale ultrasonography were: size, echotexture, internal morphology, contour, presence of microcalcification, and presence of halo sign. The evaluation criteria for color Doppler ultrasonography were: vascular flow pattern and resistive index. Vascular flow patterns were classified as Types I, II, III, and IV.Results: Irregular contour and type IV flow patterns were the most significant independent predictors of malignancy in malignant thyroid nodules. Resistive index was significantly higher in malignant nodules. The cut off value was established as resistive index ≥0.69; 91% sensitivity and 97% specificity were calculated in the identification of malignant nodules. A combination of the absence of a halo sign, type IV flow pattern, and irregular contour had the highest specificity and positive predictive value (66.7% sensitivity, 100% specificity, 100% positive predictive value, 92.3% negative predictive value). Conclusion:We believe that by the integration gray-scale ultrasonography with color Doppler ultrasonography findings, it is possible to determine which nodule is malign/benign without performing fine needle aspiration biopsy (FNAB) and unnecessary operations could be prevented.Key Words: Thyroid Nodule, Ultrasonography, Doppler Ultrasonography, Resistive Index, Vascularization Amaç: Tiroid nodüllerinde ultrasonografi bulgularına ek olarak renkliDoppler ultrasonografi bulguları ile birlikte malign -benign ayrımını yapabilmek Materyal -Metod: Çalıșmamızda total yada subtotaltiroidektomi sonucunda patolojileri bilinen 60 nodül incelenmiștir. Retrospektif olarak 60 nodülün 12'si malign karakterdeydi. Nodüllerde ultrasonografi bulguları olarak; boyut, ekojenite, natür, kenar yapısı, mikrokalsifikasyon varlığı, periferikhalo varlığı değerlendirilme-ye alındı. Renkli Doppler ultrasonografi bulguları olarak kanlanma desenlerine ve rezistif indeks değerlerine bakıldı. Kanlanma desenleri 4 sınıfta gruplandırıldı; tip I, tip II, tip III, tip IV . Bulgular: Düzensiz kenar yapısı ve tip IV kanlanma deseni malignnodül saptamada en özgül bağımsız parametreler olarak saptandı. Rezistif indeks değeri malignnodüllerde daha yüksek bulundu. Rezistif indeks için cutoff değeri % 91 duyarlılık ve % 97 özgüllük ile 0,69 olarak hesaplandı. Düzensiz kenar yapısı, periferikhalo kaybı ve tip IV kanlanma deseni kombinasyonu malignnodül saptamada en özgül ve en yüksek pozitif tahmini değere sahip bulgu olarak bulundu (% 66.7 duyarlılık, %100 özgüllük, %100 pozitiftahminideğer, %92.3 negatif tahmini değer).Sonuç: Ultrasonografik ile renkli Doppler ultrasonografi bulguları birlikte malign -benign nodül ayrımı yapılabilir ve gereksiz cerrahi ișlem eng...

show abstract

Section: Discussionsupporting

confidence: 50%

mentioning

confidence: 85%

See 1 more Smart Citation

Ultrasonographic and color doppler ultrasonographic parameters to discriminate thyroid nodules

ÇORUH¹,

AKKAYA²,

ÖZTUNA³

et al. 2016

Ankara Üniversitesi Tıp Fakültesi Mecmuası

View full text Add to dashboard Cite

show abstract

“…Of these, 235 studies were retrieved for further investigation, and 41 studies (14,15,16,17,18,19,20,21,22,23,24,25,26,27,28,29,30,31,32,33,34,35,36,37,38,39,40,41,42,43,44,45,46,47,48,49,50,51,52,53,54) met the final selection criteria and were included in the analysis. All 41 studies were observational studies published in peer-reviewed journals between 1989 and 2012.…”

Section: Search Results and Study Characteristicsmentioning

confidence: 99%

DIAGNOSIS IN ENDOCRINOLOGY: Quantification of cancer risk of each clinical and ultrasonographic suspicious feature of thyroid nodules: a systematic review and meta-analysis

Campanella

Ianni

Rota

et al. 2014

European Journal of Endocrinology

108

View full text Add to dashboard Cite

Objective: In order to quantify the risk of malignancy of clinical and ultrasonographic features of thyroid nodules (TNs), we did a systematic review and meta-analysis of published studies. Methods: We did a literature search in MEDLINE for studies published from 1st January 1989 until 31st December 2012. Studies were considered eligible if they investigated the association between at least one clinical/ultrasonographic feature and the risk of malignancy, did not have exclusion criteria for the detected nodules, had histologically confirmed the diagnoses of malignancy, and had a univariable analysis available. Two reviewers independently extracted data on study characteristics and outcomes. Results: The meta-analysis included 41 studies, for a total of 29 678 TN. A higher risk of malignancy expressed in odds ratio (OR) was found for the following: nodule height greater than width (OR: 10.15), absent halo sign (OR: 7.14), microcalcifications (OR: 6.76), irregular margins (OR: 6.12), hypoechogenicity (OR: 5.07), solid nodule structure (OR: 4.69), intranodular vascularization (OR: 3.76), family history of thyroid carcinoma (OR: 2.29), nodule size R4 cm (OR: 1.63), single nodule (OR: 1.43), history of head/neck irradiation (OR: 1.29), and male gender (OR: 1.22). Interestingly, meta-regression analysis showed a higher risk of malignancy for hypoechoic nodules in iodine-sufficient than in iodine-deficient geographical areas. Conclusions: The current meta-analysis verified and weighed out each suspicious clinical and ultrasonographic TN feature. The highest risk was found for nodule height greater than width, absent halo sign, and microcalcifications for ultrasonographic features and family history of thyroid carcinoma for clinical features. A meta-analysis-derived grading system of TN malignancy risk, validated on a large prospective cohort, could be a useful tool in TN diagnostic work-up.

show abstract

“…After B-mode US, power Doppler and duplex imaging were performed. Vascularization of thyroid nodules was classified using five different patterns as described previously [22]: pattern 0: no visible flow; pattern 1: minimal internal flow without a peripheral ring; pattern 2: peripheral ring of flow but minimal or no internal flow; pattern 3: peripheral ring of flow and moderate amount of internal flow; pattern 4: extensive internal flow with or without a peripheral ring. In patients with a goiter and multiple nodules, up to 4 nodules per patient, which fulfilled at least 2 ultrasound criteria of malignancy, could be included.…”

Section: Conventional Ultrasound (B-mode Doppler)mentioning

confidence: 99%

Evaluation of Strain Elastography for Differentiation of Thyroid Nodules: Results of a Prospective DEGUM Multicenter Study

et al. 2016

View full text Add to dashboard Cite

▼Purpose: Many patients with thyroid nodules are presently referred to surgery for not only therapeutic but also diagnostic purposes. The aim of noninvasive diagnostic methods is to optimize the selection of patients for surgery. Strain elastography (SE) enables the ultrasound-based determination of tissue elasticity. The aim of the present study was to evaluate the value of SE for the differentiation of thyroid nodules in a prospective multicenter study. Materials and Methods: The study was registered at clinicaltrials.gov and was approved by the local ethics committees of all participating centers. All patients received an ultrasound (US) of the thyroid gland including color Doppler US. In addition, all nodules were evaluated by SE (Hitachi Medical Systems) using qualitative image interpretation of color distribution (SE-ES), strain value and strain ratio. Results: Overall, 602 patients with 657 thyroid nodules (567 benign, 90 malignant) from 7 centers were included in the final analysis. The sensitivity, specificity, NPV, PPV, +LR were 21 %, 73 %, 86 %, 11 %, 0.8, respectively, for color Doppler US; 69 %, 75 %, 94 %, 30 %, 2.9, respectively, for SE-ES; 56 %, 81 %, 92 %, 32 %, 2.9, respectively, for SEstrain value; and 58 %, 78 %, 92 %, 30 %, 2.6, respectively, for SE-strain ratio. The diagnostic accuracy was 71 % for both strain value and strain ratio of nodules. Conclusion: SE as an additional ultrasound tool improves the value of ultrasound for the workup of thyroid nodules. It might reduce diagnostic surgery of thyroid nodules in the future. Zusammenfassung ▼Ziel: Viele Patienten mit Schilddrüsenknoten werden nicht nur therapeutisch, sondern auch zu diagnostischem Zweck operiert. Ziel von nicht-invasiven diagnostischen Verfahren ist es daher die Selektion von Patienten zur Operation zu optimieren. Strain Elastografie (SE) ermöglicht die Ultraschall-basierte Messung der Gewebeelastizität. Das Ziel der vorliegenden Studie war es den Stellenwert der SE in einer prospektiven Multizenter-Studie für die Differenzierung von Schilddrüsenknoten zu evaluieren. Material und Methoden: Die Studie wurde bei clinicaltrials.gov registriert und von den lokalen Ethikkommissionen der teilnehmenden Zentren genehmigt. Alle Patienten erhielten einen Ultraschall (US) der Schilddrüse inklusive Farbduplex-US. Zusätzlich wurden alle Knoten mittels SE (Hitachi Medical System) untersucht und eine Beurteilung der qualitativen Farbverteilung (SE-ES) und eine semiquantitative Messung der Elastizität mittels strain value und strain ratio durchgeführt. Ergebnisse: Insgesamt wurden 602 Patienten mit 657 Schilddrüsenknoten (567 benigne, 90 maligne) an 7 deutschen Zentren ausgewertet. Sensitivität, Spezifität, NPV, PPV, und +LR betrugen entsprechend 21 %, 73 %, 86 %, 11 %, 0,8 für den Duplex-US; 69 %, 75 %, 94 %, 30 %, 2,9 für SE-ES; 56 %, 81 %, 92 %, 32 %, 2,9 für SE-strain value; 58 %, 78 %, 92 %, 30 %, 2,6 für SE-strain ratio. Die diagnostische Genauigkeit betrug 71 % sowohl für SEstrain value, als auch SE-strain ratio. Schlussfo...

show abstract

Vascularisation of Benign and Malignant Thyroid Nodules: CD US Evaluation

Cited by 44 publications

References 8 publications

Ultrasonographic and color doppler ultrasonographic parameters to discriminate thyroid nodules

Ultrasonographic and color doppler ultrasonographic parameters to discriminate thyroid nodules

DIAGNOSIS IN ENDOCRINOLOGY: Quantification of cancer risk of each clinical and ultrasonographic suspicious feature of thyroid nodules: a systematic review and meta-analysis

Evaluation of Strain Elastography for Differentiation of Thyroid Nodules: Results of a Prospective DEGUM Multicenter Study

Contact Info

Product

Resources

About