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Li J, Zhang YR, Ren JY, Li QL, Zhu PS, Du TT, Ge XY, Chen M, Cui XW. Association between diagnostic efficacy of acoustic radiation force impulse for benign and malignant thyroid nodules and the presence or absence of non-papillary thyroid cancer: A meta-analysis. Front Oncol 2023; 13:1007464. [PMID: 36776305 PMCID: PMC9915625 DOI: 10.3389/fonc.2023.1007464] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2022] [Accepted: 01/09/2023] [Indexed: 01/30/2023] Open
Abstract
Purpose The aim of this study was to investigate the diagnostic efficacy of Acoustic Radiation Force Impulse (ARFI) for benign and malignant thyroid nodules in the presence and absence of non-papillary thyroid cancer (NPTC) and to determine the cut-off values of Shear Wave Velocity (SWV) for the highest diagnostic efficacy of Virtual Touch Quantification (VTQ) and Virtual Touch Tissue Imaging and Quantification (VTIQ). Methods The diagnostic accuracy of ARFI for benign and malignant thyroid nodules was assessed by pooling sensitivity, specificity and area under the curve (AUC) in each group in the presence and absence of both non-papillary thyroid glands, using histology and cytology as the gold standard. All included studies were divided into two groups according to VTQ and VTIQ, and each group was ranked according to the magnitude of the SWV cutoff value to determine the SWV cutoff interval with the highest diagnostic efficacy for VTQ and VTIQ. Results A total of 57 studies were collected on the evaluation of ARFI for the diagnosis of benign and malignant thyroid nodules. The results showed that the presence of non-papillary thyroid carcinoma led to differences in the specificity of VTIQ for the identification of benign and malignant thyroid nodules, and the differences were statistically significant. In addition, the diagnostic efficacy of VTQ was best when the cutoff value of SWV was in the interval of 2.48-2.55 m/s, and the diagnostic efficacy of VTIQ was best when the cutoff value of SWV was in the interval of 3.01-3.15 m/s. Conclusion VTQ and VTIQ have a high diagnostic value for benign and malignant thyroid nodules; however, when the malignant nodules in the study contain non-papillary thyroid carcinoma occupying the thyroid gland, the findings should be viewed in a comprehensive manner.
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Affiliation(s)
- Jun Li
- Department of Ultrasound, First Affiliated Hospital, School of Medicine, Shihezi University, Shihezi, China,*Correspondence: Jun Li, ; Xin Wu Cui,
| | - Yu-Rui Zhang
- Department of Ultrasound, First Affiliated Hospital, School of Medicine, Shihezi University, Shihezi, China
| | - Jia-Yu Ren
- Department of Medical Ultrasound, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Qiao-Li Li
- Department of Ultrasound, First Affiliated Hospital, School of Medicine, Shihezi University, Shihezi, China
| | - Pei-Shan Zhu
- Department of Ultrasound, First Affiliated Hospital, School of Medicine, Shihezi University, Shihezi, China
| | - Ting-Ting Du
- Department of Ultrasound, First Affiliated Hospital, School of Medicine, Shihezi University, Shihezi, China
| | - Xiao-Yan Ge
- Department of Ultrasound, First Affiliated Hospital, School of Medicine, Shihezi University, Shihezi, China
| | - Ming Chen
- Department of Ultrasound, First Affiliated Hospital, School of Medicine, Shihezi University, Shihezi, China
| | - Xin Wu Cui
- Department of Medical Ultrasound, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China,*Correspondence: Jun Li, ; Xin Wu Cui,
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DEMİRPOLAT G, TUNA L, KAVUKCU G, ERTAN Y, PAKSOY S, ÇEVİK C. MALİGN VE BENİGN TIROİD NODÜLLERİNİN AYRIMINDA ARFI ELASTOGRAFİ. EGE TIP DERGISI 2022. [DOI: 10.19161/etd.1059236] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
AMAÇ: Malign ve benign tiroid nodüllerini ayırd etmede “Acoustic Radiation Force Impulse” (ARFI) elastografinin “virtual touch tissue elastografi” modunun tanısal performansını değerlendirmek
MATERYAL VE METOD:
Çapı > 5 mm olan ikiyüzdört adet solid ve ağırlıklı solid nodül prospektif olarak ultrasonografi, ARFI elastografinin VTQ modu, ince iğne aspirasyon biyopsisi ve endike olduğunda doku patolojisi ile değerlendirildi. Yüzdoksanaltı nodülde üç makaslama dalgası hızı (shear wave velocity-SWV) ölçümü yapıldı. Her bir nodül için SWV oranı, nodülün SWV'sinin ortalama değerinin komşu parankimin ortalama değerine bölünmesiyle hesaplandı. SWV değeri ve SWV oranının tanısal performansı, ROC analizi ile değerlendirildi.
SONUÇLAR:
Benign ve malign tiroid nodüllerinde normal parankimdeki ortalama SWV değeri sırasıyla 2,13±0,44 m/s, 2,06±0,80 m/s ve 2,06±0,88 m/s idi. SWVoranları benign tiroid nodülleri için 0.97±0.37 ve malign tiroid nodülleri için 1.02±0.40 idi. Ortalama SWV değerleri (t=0,008) (P=0,994) veya SWV oranları (t=0,596; P=0,527) açısından benign ve malign nodüller arasında anlamlı fark yoktu. Maligniteyi öngörmek için herhangi bir cut-off noktası bulunmadı. Alt grup analizinde, SWV ve SWV oranı için AUC'ler, ˂10 mm ve ≥10 mm nodüller arasında önemli ölçüde farklıydı. Bunun dışında herhangi iki grup arasında anlamlı fark saptanmadı (tümü P>0.05). SWV ve SWV oranı için en iyi cut-off noktaları, <10 mm nodüller için sırasıyla SWV için 2.59 m/s ve SWV oranı için 1.0 idi.
SONUÇ: ARFİ görüntülemenin VTQ modu, maligniteyi saptamak için iyi bir tanısal performansa sahip değildir ve gereksiz tiroid biyopsilerinin azaltılmasına katkıda bulunamaz.
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DEMİRPOLAT G, TUNA L, KAVUKCU G, ERTAN Y, PAKSOY S, ÇEVİK C. Malign ve benign tiroid nodüllerinin ayrımında ARFI elastografi. EGE TIP DERGISI 2022. [DOI: 10.19161/etd.1167252] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Aim: To examine the diagnostic performance of virtual touch tissue quantification (VTQ) mode of Acoustic Radiation Force Impulse (ARFI) elastography imaging in differentiating benign and malignant thyroid nodules.
Materials and Methods: Two hundred four solid and mostly solid nodules >5mm were prospectively evaluated with ultrasonography, VTQ mode of ARFI elastography, fine needle aspiration biopsy, and when indicated with tissue pathology. Three shear-wave velocities (SWV) measurements were done in 196 nodules. The SWV ratio for each nodule was calculated as the mean value of the SWV of the nodule divided by the mean value of the adjacent parenchyma. The diagnostic performance of SWV value and SWV-ratio were assessed by a receiver-operating characteristic (ROC) curve analysis.
Results: The mean SWV value in the normal parenchyma, in benign and malign thyroid nodules, were 2.13±0.44 m/s, 2.06±0.80 m/s, and 2.06±0.88 m/s respectively. The SWV-ratios were 0.97±0.37 for benign thyroid nodules and 1.02±0.40 for malignant thyroid nodules. There was no significant difference between benign and malign nodules in terms of mean SWV values (t=0.008) (P=0.994) or SWV-ratios (t =0.596; P=0.527). No cut-off point was found to predict malignancy. In subgroup analysis, AUCs for the SWV and SWV-ratio were significantly different between nodules ˂10 mm and those ≥10 mm, but not with any other two groups (all P>0.05) (Table-2). The cutoff points for the differential diagnosis were 2.59 m/s for SWV and 1.0 for SWV- ratio respectively for nodules
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Affiliation(s)
- Gülen DEMİRPOLAT
- Department of Radiology Balikesir University Faculty of Medicine Cagıs Yerleskesi, Balıkesir, Türkiye
| | - Lale TUNA
- Kırklareli Training and Research Hospital, Department of Radiology, Kırklareli, Türkiye
| | - Gülgün KAVUKCU
- Department of Radiology, Ege University Faculty of Medicine, Izmir, Türkiye
| | - Yeşim ERTAN
- Department of Pathology, Ege University Faculty of Medicine, Izmir, Türkiye
| | - Serpil PAKSOY
- Department of Pathology, Balıkesir University Faculty of Medicine Balikesir University School of Medicine, Cagıs Yerleskesi, Balıkesir, Türkiye
| | - Celalettin ÇEVİK
- Department of Public Health Nursing Balikesir University Faculty of Health Science Cagıs Yerleskesi, Balıkesir, Türkiye
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Zhao N, Chen J, Yao M, Han R. The diagnostic value of the different acoustic radiation force impulse technique for solid thyroid nodules with different diameters: A case–control study. Asian J Surg 2022; 45:2246-2252. [DOI: 10.1016/j.asjsur.2021.12.056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Revised: 11/02/2021] [Accepted: 12/03/2021] [Indexed: 12/01/2022] Open
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Pei S, Zhang B, Cong S, Liu J, Wu S, Dong Y, Zhang L, Zhang S. Ultrasound Real-Time Tissue Elastography Improves the Diagnostic Performance of the ACR Thyroid Imaging Reporting and Data System in Differentiating Malignant from Benign Thyroid Nodules: A Summary of 1525 Thyroid Nodules. Int J Endocrinol 2020; 2020:1749351. [PMID: 32351557 PMCID: PMC7178472 DOI: 10.1155/2020/1749351] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2019] [Revised: 02/24/2020] [Accepted: 03/11/2020] [Indexed: 01/21/2023] Open
Abstract
BACKGROUND To explore the correlation between the ultrasound elasticity score (ES) of real-time tissue elastography (RTE) and the malignant risk stratification of the Thyroid Imaging Reporting and Data System (TI-RADS) and to evaluate the added value of RTE to TI-RADS in differentiating malignant nodules from benign ones. METHODS A total of 1,498 patients (885 women and 613 men; mean age of 43.5 ± 12.4 years) with 1,525 confirmed thyroid nodules (D = maximum diameter, D ≤ 2.5 cm) confirmed by fine-needle aspiration (FNA) and/or surgery were included. The nodules were divided into four groups based on their sizes (D ≤ 0.5 cm, 0.5 < D ≤ 1.0 cm, 1.0 < D ≤ 2.0 cm, and 2.0 < D ≤ 2.5 cm). We assigned an ES of RTE and malignant risk stratification of the TI-RADS category to each nodule. The correlation between the ES of RTE and the malignant risk stratification of TI-RADS category was analyzed by the Spearman's rank correlation. The diagnostic performances of RTE, TI-RADS, and their combination were compared by the receiver operator characteristic (ROC) analysis. RESULTS The ES of RTE and the malignant risk stratification of TI-RADS showed a strong correlation in the size intervals of 0.5 < D ≤ 1.0 cm, 1.0 < D ≤ 2.0 cm, and 2.0 < D ≤ 2.5 cm (r = 0.768, 0.711, and 0.743, respectively). The diagnostic performance of their combination for each size interval was always better than RTE or TI-RADS alone (for all, P < 0.001). CONCLUSIONS Overall, The ES of RTE was strongly correlated with the malignant risk stratification of TI-RADS. The diagnostic performance of the combination of RTE and TI-RADS outperformed RTE or TI-RADS alone. Therefore, RTE may be an adjunctive tool to the current TI-RADS system for differentiating malignant from benign thyroid nodules.
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Affiliation(s)
- Shufang Pei
- Department of Ultrasound, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong, China
| | - Bin Zhang
- Department of Radiology, The First Affiliated Hospital, Jinan University, Guangzhou, Guangdong, China
| | - Shuzhen Cong
- Department of Ultrasound, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong, China
- The Second School of Clinical Medicine, Southern Medical University, Guangzhou, Guangdong, China
| | - Juanjuan Liu
- Department of Ultrasound, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong, China
| | - Suqing Wu
- Department of Ultrasound, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong, China
| | - Yuhao Dong
- Department of Radiology, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong, China
| | - Lu Zhang
- Department of Radiology, The First Affiliated Hospital, Jinan University, Guangzhou, Guangdong, China
| | - Shuixing Zhang
- Department of Radiology, The First Affiliated Hospital, Jinan University, Guangzhou, Guangdong, China
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Kyriakidou G, Friedrich-Rust M, Bon D, Sircar I, Schrecker C, Bogdanou D, Herrmann E, Bojunga J. Comparison of strain elastography, point shear wave elastography using acoustic radiation force impulse imaging and 2D-shear wave elastography for the differentiation of thyroid nodules. PLoS One 2018; 13:e0204095. [PMID: 30222755 PMCID: PMC6141102 DOI: 10.1371/journal.pone.0204095] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2017] [Accepted: 09/04/2018] [Indexed: 12/31/2022] Open
Abstract
PURPOSE The aim of the study was to compare three different elastography methods, namely Strain Elastography (SE), Point Shear-Wave Elastography (pSWE) using Acoustic Radiation Force Impulse (ARFI)-Imaging and 2D-Shear Wave Elastography (2D-SWE), in the same study population for the differentiation of thyroid nodules. MATERIALS AND METHODS All patients received a conventional ultrasound scan, SE and 2D-SWE, and all patients except for two received ARFI-Imaging. Cytology/histology of thyroid nodules was used as a reference method. SE measures the relative stiffness within the region of interest (ROI) using the surrounding tissue as reference tissue. ARFI mechanically excites the tissue at the ROI using acoustic pulses to generate localized tissue displacements. 2D-SWE measures tissue elasticity using the velocity of many shear waves as they propagate through the tissue. RESULTS 84 nodules (73 benign and 11 malignant) in 62 patients were analyzed. Sensitivity, specificity and NPV of SE were 73%, 70% and 94%, respectively. Sensitivity, specificity and NPV of ARFI and 2D-SWE were 90%, 79%, 98% and 73%, 67%, 94% respectively, using a cut-off value of 1.98m/s for ARFI and 2.65m/s (21.07kPa) for 2D-SWE. The AUROC (Area under the Receiver Operating Characteristic) of SE, ARFI and 2D-SWE for the diagnosis of malignant thyroid nodules were 52%, 86% and 71%, respectively. A significant difference in AUROC was found between SE and ARFI (p = 0.008), while no significant difference was found between ARFI and SWE (86% vs. 71%, p = 0.31), or SWE and SE (71% vs. 52%, p = 0.26). CONCLUSION pSWE using ARFI and 2D-SWE showed comparable results for the differentiation of thyroid nodules. ARFI was superior to elastography using SE.
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Affiliation(s)
- Georgia Kyriakidou
- Department of Internal Medicine 1, J.W. Goethe-University Hospital, Frankfurt, Germany
- * E-mail:
| | - Mireen Friedrich-Rust
- Department of Internal Medicine 1, J.W. Goethe-University Hospital, Frankfurt, Germany
| | - Dimitra Bon
- Institute of Biostatistics and Mathematical Modeling, Faculty of Medicine, J.W. Goethe-University, Frankfurt, Germany
| | - Ishani Sircar
- Department of Internal Medicine 1, J.W. Goethe-University Hospital, Frankfurt, Germany
| | - Christopher Schrecker
- Department of Internal Medicine 1, J.W. Goethe-University Hospital, Frankfurt, Germany
| | - Dimitra Bogdanou
- Department of Internal Medicine 1, J.W. Goethe-University Hospital, Frankfurt, Germany
| | - Eva Herrmann
- Institute of Biostatistics and Mathematical Modeling, Faculty of Medicine, J.W. Goethe-University, Frankfurt, Germany
| | - Joerg Bojunga
- Department of Internal Medicine 1, J.W. Goethe-University Hospital, Frankfurt, Germany
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Jin XZ, Lu WW, Zhang HF, Yan YY, Gu XL. Comparative study on the diagnostic values of different ultrasound technologies for malignant thyroid nodules. Oncol Lett 2018; 16:910-914. [PMID: 29963163 PMCID: PMC6019883 DOI: 10.3892/ol.2018.8706] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2017] [Accepted: 01/25/2018] [Indexed: 12/11/2022] Open
Abstract
The present study compared and analyzed the diagnostic values of B-mode ultrasound and elasticity imaging technology for the identification of benign and malignant thyroid nodules. Ninety-four patients who were diagnosed with thyroid nodules by ultrasound were chosen. All patients were checked with B-mode ultrasound and ultrasound elasticity imaging technology before surgeries. Further, the post-operative outcomes were compared with operation pathology. The pathological examination results were taken as the gold standard. The accuracy, sensitivity, specificity, positive predictive value and negative predictive values of combined ultrasound diagnosis were all obviously higher than those by the B-mode ultrasound and the ultrasound elastography method (P<0.05). In conclusion, as a new technology, ultrasound elasticity imaging technology has relatively high diagnositic value in identifying benign and malignant thyroid nodules. With its own advantages and limitations, the ultrasound elasticity imaging technology could effectively complement B-mode ultrasound, and improve the sensitivity, specificity and accuracy of ultrasound diagnosis for thyroid nodules.
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Affiliation(s)
- Xiao-Zhu Jin
- Department of Ultrasonography, Zhengzhou Central Hospital Affiliated to Zhengzhou University, Zhengzhou, Henan 450000, P.R. China
| | - Wei-Wei Lu
- Department of Ultrasonography, The First People's Hospital of Shangqiu, Shangqiu, Henan 476000, P.R. China
| | - Hai-Feng Zhang
- Department of Radiology, Zhengzhou Central Hospital Affiliated to Zhengzhou University, Zhengzhou, Henan 450000, P.R. China
| | - Yuan-Yuan Yan
- Department of Ultrasonography, Zhengzhou Central Hospital Affiliated to Zhengzhou University, Zhengzhou, Henan 450000, P.R. China
| | - Xiao-Le Gu
- Department of Ultrasonography, Zhengzhou Central Hospital Affiliated to Zhengzhou University, Zhengzhou, Henan 450000, P.R. China
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Chang N, Zhang X, Wan W, Zhang C, Zhang X. The Preciseness in Diagnosing Thyroid Malignant Nodules Using Shear-Wave Elastography. Med Sci Monit 2018; 24:671-677. [PMID: 29391387 PMCID: PMC5806774 DOI: 10.12659/msm.904703] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Our study aimed to identify more accurate results about the diagnostic role of shear-wave elastography (SWE) for thyroid malignant nodules through a meta-analysis. Potential articles were searched in PubMed, Embase, and the Cochrane Library databases. Overall sensitivity and specificity with 95% confidence intervals (CIs) was used to represent the diagnostic accuracy of SWE. Summary receiver operating characteristic (ROC) curve was constructed to illustrate the results. In addition, χ2 and I2 tests were performed to assess heterogeneity. A value of p≤0.05 indicated significant heterogeneity. All the analysis was conducted in Meta-DiSc version 1.4 software. Twenty studies were included in the analysis. There were a total of 2,907 patients and 3,397 thyroid nodules included in the meta-analysis. Overall sensitivity and specificity were 0.68 (95% CI: 0.66–0.70) and 0.85 (95% CI: 0.84–0.87), respectively. The results showed the area under curve (AUC) was 0.9041, suggesting high accuracy of SWE for differentiating benign and malignant thyroid nodules. SWE showed high accuracy in identifying thyroid malignant nodules, suggesting it could serve as a diagnostic biomarker in thyroid nodules.
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Affiliation(s)
- Na Chang
- Department of Medical Imaging, Shandong University, Jinan, Shandong, China (mainland).,Department of Medical Imaging, Jinan Vocational College of Nursing, Jinan, Shandong, China (mainland)
| | - Xianchao Zhang
- Department of Oncology, Xintai People's Hospital, Xintai, Shandong, China (mainland)
| | - Wenjing Wan
- Department of Nephrology, Xintai People's Hospital, Xintai, Shandong, China (mainland)
| | - Chengqi Zhang
- Department of Medical Imaging, Qianfoshan Hospital, Shandong University, Jinan, Shandong, China (mainland)
| | - Xianqi Zhang
- Department of Thoracic Surgery, Qianfoshan Hospital, Shandong University, Jinan, Shandong, China (mainland)
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Chandramohan A, Therese M, Abhraham D, Paul TV, Mazhuvanchary PJ. Can ARFI elastography be used to differentiate parathyroid from thyroid lesions? J Endocrinol Invest 2018; 41:111-119. [PMID: 28569362 DOI: 10.1007/s40618-017-0694-y] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2017] [Accepted: 05/16/2017] [Indexed: 10/19/2022]
Abstract
OBJECTIVES To assess if elasticity score (ES) and shear wave velocity (SWV) measurement obtained using ARFI elastography can differentiate between parathyroid lesions and thyroid nodules. MATERIALS AND METHODS ARFI elastography was performed on patients with primary hyperparathyroidism or solid thyroid nodules who were being considered for surgery using virtual touch quantification and virtual touch imaging (VTI) software. Only patients with surgical histopathology (47 parathyroid lesions, 38 benign thyroid nodules and 55 malignant thyroid nodules) were included for final analysis. SWV and ES of the parathyroid and thyroid nodules were compared and their ability to differentiate between parathyroid and thyroid was analyzed using receiver operating characteristic curve analysis. RESULTS There were 39 solitary adenomas, 2 double adenomas and 4 parathyroid hyperplasias with mean size of 19.6 ± 9.7 mm in 44 patients (21 male, 23 females) with primary hyperparathyroidism. The mean SWV of the parathyroid lesion (1.6 ± 0.78 m/s) was significantly different from benign (2.11 ± 0.8 m/s) and malignant (4.3 ± 2.71 m/s) thyroid nodules, p < 0.05; so was the ES, Chi square = 51.6, p < 0.001. The majority of parathyroid lesions (n = 37, 78.7%) had ES of 2 with speckled (n = 42, 89.3%) appearance, and none showed ES of 4. The diagnostic performance of speckled appearance on VTI, elasticity score and SWV measurements was 0.901, 0.724 and 0.797, respectively, to differentiate between parathyroid and thyroid lesions. CONCLUSIONS Parathyroid lesions are softer than thyroid nodules. A shear wave velocity of 1.72 m/s can differentiate between parathyroid lesions and thyroid nodules.
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Affiliation(s)
- A Chandramohan
- Christian Medical College and Hospital Vellore, Vellore, Tamil Nadu, India.
| | - M Therese
- Christian Medical College and Hospital Vellore, Vellore, Tamil Nadu, India
| | - D Abhraham
- Christian Medical College and Hospital Vellore, Vellore, Tamil Nadu, India
| | - T V Paul
- Christian Medical College and Hospital Vellore, Vellore, Tamil Nadu, India
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Turhal G, Göde S, Tunakan Dalgıç C, Sin AZ, Kısmalı E, Kaya İ, Öztürk A, Göksel Ö, Midilli R, Öztürk K, Karcı B. Evaluation of Inferior Turbinate Stroma with Ultrasound Elastography in Allergic Rhinitis Patients. Balkan Med J 2017; 34:318-322. [PMID: 28443598 PMCID: PMC5615964 DOI: 10.4274/balkanmedj.2016.1339] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
Background: Diagnosis of allergic rhinitis is primarily based on history, physical examination and allergy testing. A technique that noninvasively evaluates the soft tissue changes in the nasal mucosa of allergic rhinitis patients has not been defined. Aims: To assess nasal mucosal changes and measure the submucosal fibrosis in allergic rhinitis patients with sonoelastography. Study Design: Case control study. Methods: Eighty-eight turbinates of 44 patients were included in the study. There were 23 prick test positive allergic rhinitis patients. The control group constituted 21 patients. The rhinitis quality of life questionnaire and the visual analogue scale were applied to the allergic rhinitis patients. A higher visual analogue scale score indicated more severe allergic rhinitis symptoms. Sonoelastographic measurements were made from the lateral nasal wall. The propagation speed of sound waves was recorded in m/s. The presence of asthma and the type of allergic rhinitis (seasonal or perennial) was noted. Results: Ten patients had seasonal allergic rhinitis and thirteen patients had perennial allergic rhinitis. Six patients (26.1%) had accompanying asthma along with allergic rhinitis. The median visual analogue scale score was 7 (3-9) in allergic rhinitis patients. The median symptom duration was 7 (1-24) months. The median quality of life questionnaire score was 3.39 (1.68-5.43) points. The median sonoelastography scores of allergic rhinitis patients and healthy subjects were 2.38 m/s (0.9-4.47) and 2.42 m/s (1.62-3.50), respectively. Sonoelastographic measurements of seasonal and perennial allergic rhinitis patients did not differ significantly (p>0.05). The presence of asthma did not have a significant impact on the elastography measurements (p>0.05). However, regression analysis revealed a significant inverse correlation (coefficients: B=0.005, standard error=0.097, beta 0=0.008) between the visual analogue scale and sonoelastography scores (p<0.05). Conclusion: Sonoelastography was not suitable as a diagnostic tool in allergic rhinitis. Reduced sonoelastography scores were measured in more symptomatic patients. Higher visual analogue scale scores could be an indicator of disease severity.
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Affiliation(s)
- Göksel Turhal
- Department of Otolaryngology, Ege University School of Medicine, İzmir, Turkey
| | - Sercan Göde
- Department of Otolaryngology, Ege University School of Medicine, İzmir, Turkey
| | - Ceyda Tunakan Dalgıç
- Department of Allergy and Immunology, Ege University School of Medicine, İzmir, Turkey
| | - Aytül Zerrin Sin
- Department of Allergy and Immunology, Ege University School of Medicine, İzmir, Turkey
| | - Erkan Kısmalı
- Department of Radiology, Ege University School of Medinice, İzmir, Turkey
| | - İsa Kaya
- Department of Otolaryngology, Ege University School of Medicine, İzmir, Turkey
| | - Arın Öztürk
- Department of Otolaryngology, Ege University School of Medicine, İzmir, Turkey
| | - Özlem Göksel
- Department of Pulmonology, Ege University School of Medicine, İzmir, Turkey
| | - Raşit Midilli
- Department of Otolaryngology, Ege University School of Medicine, İzmir, Turkey
| | - Kerem Öztürk
- Department of Otolaryngology, Ege University School of Medicine, İzmir, Turkey
| | - Bülent Karcı
- Department of Otolaryngology, Ege University School of Medicine, İzmir, Turkey
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Zhou H, Zhou XL, Xu HX, Li DD, Liu BJ, Zhang YF, Xu JM, Bo XW, Li XL, Guo LH, Qu S. Virtual Touch Tissue Imaging and Quantification in the Evaluation of Thyroid Nodules. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2017; 36:251-260. [PMID: 27914177 DOI: 10.7863/ultra.15.12070] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/28/2015] [Accepted: 05/23/2016] [Indexed: 06/06/2023]
Abstract
OBJECTIVES To investigate the diagnostic performance of a 2-dimensional shear wave elastographic technique (Virtual Touch tissue imaging and quantification [VTIQ]; Siemens Medical Solutions, Mountain View, CA) for predicting thyroid malignancy. METHODS A total of 302 thyroid nodules underwent conventional sonography and VTIQ before fine-needle aspiration examination or surgery. Compared with histopathologic or cytologic results in combination with follow-up, the diagnostic performance of various shear wave speed (SWS) indices (minimum [SWSmin ], maximum [SWSmax ], and mean [SWSmean ]) on VTIQ as well as conventional sonographic features for predicting thyroid malignancy was evaluated in all of the nodules. RESULTS Sixty-five malignant and 237 benign thyroid nodules were histopathologically or cytologically confirmed. All SWS indices on VTIQ were lower in benign nodules than thyroid malignancy (all P < .001). For discrimination between malignant and benign nodules, all VTIQ SWS indices were better than conventional sonographic features, such as a solid component, a taller-than-wide shape, microcalcification, a poorly defined margin and hypoechogenicity, in predicting thyroid malignancy (all P < .05). By applying a cutoff SWSmean value of 2.60 m/s, VTIQ achieved sensitivity and negative predictive values of 84.6% and 94.3%, respectively, for differentiating nodules. The areas under the receiver operating characteristic curve of SWSmax (0.862 versus 0.717), SWSmin (0.866 versus 0.717), and SWSmean (0.891 versus 0.725) for nodules larger than 10 mm were higher than those for nodules of 10 mm or smaller (all P < .05). Interoperator and intraoperator reproducibility was proven to be excellent, with all interclass correlation coefficient values higher than 0.80 (range, 0.813-0.905) CONCLUSIONS: Virtual Touch tissue imaging and quantification is a useful and reproducible tool for predicting thyroid malignancy.
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Affiliation(s)
- Hang Zhou
- Department of Medical Ultrasound, Shanghai Tenth People's Hospital, Ultrasound Research and Education Institute, Tongji University School of Medicine, Shanghai, China
- Inpatient Ultrasound Department, Second Affiliated Hospital of Harbin Medical University, Harbin, China
- Thyroid Institute, Tongji University School of Medicine, Shanghai, China
| | - Xian-Li Zhou
- Inpatient Ultrasound Department, Second Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Hui-Xiong Xu
- Department of Medical Ultrasound, Shanghai Tenth People's Hospital, Ultrasound Research and Education Institute, Tongji University School of Medicine, Shanghai, China
- Thyroid Institute, Tongji University School of Medicine, Shanghai, China
| | - Dan-Dan Li
- Department of Medical Ultrasound, Shanghai Tenth People's Hospital, Ultrasound Research and Education Institute, Tongji University School of Medicine, Shanghai, China
- Thyroid Institute, Tongji University School of Medicine, Shanghai, China
| | - Bo-Ji Liu
- Department of Medical Ultrasound, Shanghai Tenth People's Hospital, Ultrasound Research and Education Institute, Tongji University School of Medicine, Shanghai, China
- Thyroid Institute, Tongji University School of Medicine, Shanghai, China
| | - Yi-Feng Zhang
- Department of Medical Ultrasound, Shanghai Tenth People's Hospital, Ultrasound Research and Education Institute, Tongji University School of Medicine, Shanghai, China
- Thyroid Institute, Tongji University School of Medicine, Shanghai, China
| | - Jun-Mei Xu
- Department of Medical Ultrasound, Shanghai Tenth People's Hospital, Ultrasound Research and Education Institute, Tongji University School of Medicine, Shanghai, China
- Thyroid Institute, Tongji University School of Medicine, Shanghai, China
| | - Xiao-Wan Bo
- Department of Medical Ultrasound, Shanghai Tenth People's Hospital, Ultrasound Research and Education Institute, Tongji University School of Medicine, Shanghai, China
- Thyroid Institute, Tongji University School of Medicine, Shanghai, China
| | - Xiao-Long Li
- Department of Medical Ultrasound, Shanghai Tenth People's Hospital, Ultrasound Research and Education Institute, Tongji University School of Medicine, Shanghai, China
- Thyroid Institute, Tongji University School of Medicine, Shanghai, China
| | - Le-Hang Guo
- Department of Medical Ultrasound, Shanghai Tenth People's Hospital, Ultrasound Research and Education Institute, Tongji University School of Medicine, Shanghai, China
- Thyroid Institute, Tongji University School of Medicine, Shanghai, China
| | - Shen Qu
- Thyroid Institute, Tongji University School of Medicine, Shanghai, China
- Department of Endocrinology and Metabolism, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, China
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Liu BJ, Li DD, Xu HX, Guo LH, Zhang YF, Xu JM, Liu C, Liu LN, Li XL, Xu XH, Qu S, Xing M. Quantitative Shear Wave Velocity Measurement on Acoustic Radiation Force Impulse Elastography for Differential Diagnosis between Benign and Malignant Thyroid Nodules: A Meta-analysis. ULTRASOUND IN MEDICINE & BIOLOGY 2015; 41:3035-3043. [PMID: 26371402 DOI: 10.1016/j.ultrasmedbio.2015.08.003] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/07/2015] [Revised: 07/27/2015] [Accepted: 08/04/2015] [Indexed: 06/05/2023]
Abstract
The aim of this study was to evaluate the diagnostic performance of quantitative shear wave velocity (SWV) measurement on acoustic radiation force impulse (ARFI) elastography for differentiation between benign and malignant thyroid nodules using meta-analysis. The databases of PubMed and the Web of Science were searched. Studies published in English on assessment of the sensitivity and specificity of ARFI elastography for the differentiation of thyroid nodules were collected. The quantitative measurement of ARFI elastography was evaluated by SWV (m/s). Meta-Disc Version 1.4 software was used to describe and calculate the sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, diagnostic odds ratio and summary receiver operating characteristic curves. We analyzed a total of 13 studies, which included 1,854 thyroid nodules (including 1,339 benign nodules and 515 malignant nodules) from 1,641 patients. The summary sensitivity and specificity for differential diagnosis between benign and malignant thyroid nodules by SWV were 0.81 (95% confidence interval [CI]: 0.77-0.84) and 0.84 (95% CI: 0.81-0.86), respectively. The pooled positive and negative likelihood ratios were 5.21 (95% CI: 3.56-7.62) and 0.23 (95% CI: 0.17-0.32), respectively. The pooled diagnostic odds ratio was 27.53 (95% CI: 14.58-52.01), and the area under the summary receiver operating characteristic curve was 0.91 (Q* = 0.84). In conclusion, SWV measurement on ARFI elastography has high sensitivity and specificity for differential diagnosis between benign and malignant thyroid nodules and can be used in combination with conventional ultrasound.
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Affiliation(s)
- Bo-Ji Liu
- Department of Medical Ultrasound, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, China
| | - Dan-Dan Li
- Department of Medical Ultrasound, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, China
| | - Hui-Xiong Xu
- Department of Medical Ultrasound, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, China; Department of Ultrasound, Guangdong Medical College Affiliated Hospital, Zhanjiang, China; Thyroid Institute, Tongji University School of Medicine, Shanghai, China.
| | - Le-Hang Guo
- Department of Medical Ultrasound, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, China
| | - Yi-Feng Zhang
- Department of Medical Ultrasound, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, China
| | - Jun-Mei Xu
- Department of Medical Ultrasound, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, China
| | - Chang Liu
- Department of Medical Ultrasound, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, China
| | - Lin-Na Liu
- Department of Medical Ultrasound, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, China
| | - Xiao-Long Li
- Department of Medical Ultrasound, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, China
| | - Xiao-Hong Xu
- Department of Ultrasound, Guangdong Medical College Affiliated Hospital, Zhanjiang, China
| | - Shen Qu
- Thyroid Institute, Tongji University School of Medicine, Shanghai, China; Department of Endocrinology and Metabolism, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, China
| | - Mingzhao Xing
- Thyroid Institute, Tongji University School of Medicine, Shanghai, China; Department of Endocrinology, Diabetes & Metabolism, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
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Kısmalı E, Göde S, Turhal G, Öztürk K, Rașit M. A new insight for evaluation of the inferior turbinate with ultrasound elastography. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2015; 34:777-782. [PMID: 25911709 DOI: 10.7863/ultra.34.5.777] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
OBJECTIVES There are diseases that affect the stroma of the inferior turbinate and many surgical interventions that alter it. However, an objective method that can evaluate the turbinate's stromal structure in detail has not been defined yet. The primary aim of this study was to investigate the effectiveness and reliability of ultrasound elastography for objective evaluation of the inferior turbinate stroma and define the most suitable elastographic technique. METHODS Twenty inferior turbinates in 10 healthy participants were included. Five of the participants (50%) were male, and 5 (50%) were female, with a mean age ± SD of 28.3 ± 3.2 years (range, 26-35) years. To obtain reliable and reproducible results, elastography was performed twice, 3 days apart, with and without a topical decongestant to evaluate the effects of the nasal cycle and mucosal edema. Two previously described valid elastographic outcome measures were reevaluated for the inferior turbinate. The tissue strain ratio and sound wave propagation speed were calculated for each measurement. RESULTS Median propagation speeds without and with the decongestant for the first and second measurements were 2.125 (interquartile range [IQR], 0.85), 2.175 (IQR, 0.53), 2.520 (IQR, 0.79), and 2.555 (IQR, 0.53) m/s, respectively. Median turbinate stroma-to-subcutaneous tissue strain ratios without and with the decongestant for the first and second measurements were 1.402 (IQR, 0.96), 0.942 (IQR, 0.24), 1.035 (IQR, 0.98), and 1.427 (IQR, 1.68). CONCLUSIONS We suggest that elastography is a reliable and reproducible method that is not substantially affected by mucosal edema. It is a novel technique that can evaluate the inferior turbinate stroma and might be used in concordance with other objective functional techniques such as acoustic rhinometry. Therefore, it can be used in further studies regarding diagnosis of turbinate diseases and objective evaluation of previous surgical treatments.
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Affiliation(s)
- Erkan Kısmalı
- Departments of Radiology (E.K.) and Otolaryngology (S.G., G.T., K.Ö., R.M.), Ege University Medical School, Izmir, Turkey
| | - Sercan Göde
- Departments of Radiology (E.K.) and Otolaryngology (S.G., G.T., K.Ö., R.M.), Ege University Medical School, Izmir, Turkey
| | - Göksel Turhal
- Departments of Radiology (E.K.) and Otolaryngology (S.G., G.T., K.Ö., R.M.), Ege University Medical School, Izmir, Turkey
| | - Kerem Öztürk
- Departments of Radiology (E.K.) and Otolaryngology (S.G., G.T., K.Ö., R.M.), Ege University Medical School, Izmir, Turkey
| | - Midilli Rașit
- Departments of Radiology (E.K.) and Otolaryngology (S.G., G.T., K.Ö., R.M.), Ege University Medical School, Izmir, Turkey
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