Virtual touch tissue imaging and quantification (VTIQ) in the evaluation of thyroid nodules: the associated factors leading to misdiagnosis

Abstract

To evaluate the associated factors leading to misdiagnosis with VTIQ for differentiation between benign from malignant thyroid nodules (TNs). The study included 238 benign TNs and 150 malignant TNs. Conventional ultrasound (US) features and VTIQ parameters were obtained and compared with the reference standard of histopathological and/or cytological results. Binary logistic regression analysis was performed to select independent variables leading to misdiagnosis. The maximum shear wave speed (SWS) (SWS-max), mean SWS (SWS-mean), SWS-ratio and standard deviation of SWS (SWS-SD) were significantly higher for malignant TNs compared with benign TNs (all P < 0.001). SWS-mean achieved the highest diagnostic performance with a cut-off value of 3.15 m/s. False positive rate was 13.4% (32/238) while false negative rate was 35.3% (53/150). Intranodular calcification (OR: 1.715) was significantly associated with false positive VTIQ findings, while nodule size (OR: 0.936) and echotexture of the thyroid gland (OR: 0.033) were negatively associated with them. Nodule depth (OR: 0.881) and TI-RADS category (OR: 0.563) were negatively associated with false negative VTIQ findings. These US characteristic of TNs should be taken into consideration when interpreting the results of VTIQ examinations.

Use of the Kwak Thyroid Image Reporting and Data System (K-TIRADS) in differential diagnosis of thyroid nodules: systematic review and meta-analysis

“…A total of 643 publications were identified upon systematic review of the literature, of which 42 remained after removing duplicates, literature reviews, studies not related to Kwak’s TIRADS and those written in a language other than English or German. Analysis of abstracts and full texts allowed isolation of six original studies that assessed the K-TIRADS scale proposed by Kwak, consistent with the meta-analysis objectives [ 20 – 25 ] (Fig. 1 ).…”

“…In the study by Zhang and Sun, ultrasound check was also taken into account for TIRADS 2 category lesions with initial benign cytology [ 21 , 25 ] (Table 1 ). The cut-off value in four studies was category 4a/4b [ 20 , 22 – 24 ] and in last two studies category 3/4a [ 21 , 25 ]. The funnel graph for analysed studies was asymmetrical, which may suggest publication bias (Fig.…”

Ultrasound elastography of the thyroid: principles and current status

“…Elastography cannot be performed on nodules with a calcified shell because the sound waves cannot penetrate the calcifications [13]. Intralesional coarse calcifications may bias the stiffness of the lesion, as can peripheral calcifications [11,86]. A partially cystic character is expected to alter nodule elasticity, although the direction of this expected effect is not known [13,14].…”

VTIQ evaluates antitumor effects of NET‑1 siRNA by UTMD in HCC xenograft models

“…Therefore, an association between SWS and pathological processes of the tumors was not able to be established. However, this was not the aim of the present study, as previous studies have demonstrated that the difference in the stiffness is associated with tissue reorganization, particularly fibrosis and necrosis ( 2 , 47 , 52 ). Secondly, the results of these experiments are not directly applicable to human liver cancer tissues: The present tumor model was implanted under the skin of the nude mice.…”

“…The SWS mean values were markedly correlated with the tumor growth curve induced by NET-1 siRNA. However, it was also noted that comparison of the SWS max values between the two treated groups did not indicate a significant difference, which may be attributed to the location of the 7 ROIs that avoided the cystic, calcified and necrotic areas, thereby affecting the result ( 36 , 47 ). Furthermore, SWS mean achieved the highest diagnostic performance compared with the other measured values.…”