Contrast-Enhanced Ultrasound Improves the Accuracy of the ACR TI-RADS in the Diagnosis of Thyroid Nodules Located in the Isthmus

2021 ◽  
Author(s):  
Yunlin Huang ◽  
Yurong Hong ◽  
Wen Xu ◽  
Kai Song ◽  
Pintong Huang
Keyword(s):  
Diagnostic Performance ◽  
Thyroid Nodules ◽  
Characteristic Curve ◽  
Diagnostic Value ◽  
Contrast Enhanced Ultrasound ◽  
Institutional Review ◽  
Contrast Enhanced ◽  
Significant Difference ◽  
Image Reporting ◽  
Benign Nodules

Abstract Objectives To evaluate the diagnostic performance of the American College of Radiology (ACR) Thyroid Image Reporting and Data System (TI-RADS), contrast-enhanced ultrasound (CEUS), and a modified TI-RADS in differentiating benign and malignant nodules located in the isthmus. Methods This retrospective study was approved by the institutional review board. Informed consent was obtained. Grayscale ultrasound (US) and CEUS images were obtained for 203 isthmic thyroid nodules (46 benign and 157 malignant) in 198 consecutive patients (156 women, mean age: 44.7 years ± 11.3 [standard deviation]; 47 men, mean age: 40.9 years ± 11.0). The area under the receiver operating characteristic curve (AUC) of the diagnostic performance of the ACR TI-RADS, CEUS, and the modified TI-RADS were evaluated. Results Lobulated or irregular margins (P = 0.001; odds ratio [OR] = 9.250) and punctate echogenic foci (P = 0.007; OR = 4.718) on US and hypoenhancement (P < 0.001; OR = 20.888) on CEUS displayed a significant association with malignancy located in the isthmus. The most valuable method to distinguish benign nodules from malignant nodules was the modified TI-RADS (AUC: 0.863 with modified TR5), which was significantly better than the ACR TI-RADS (AUC: 0.738 with ACR TR5) (P < 0.001) but showed no significant difference with respect to CEUS (AUC: 0.835 with hypoenhancement) (P = 0.205). The diagnostic value was significantly different between CEUS and the ACR TI-RADS (P = 0.028). Conclusion The modified TI-RADS could significantly improve the accuracy of the diagnosis of thyroid nodules located in the isthmus.

scholarly journals Exploring the Value of Radiomics Features Based on B-Mode and Contrast-Enhanced Ultrasound in Discriminating the Nature of Thyroid Nodules

2021 ◽  
Vol 11 ◽  
Author(s):  
Shi Yan Guo ◽  
Ping Zhou ◽  
Yan Zhang ◽  
Li Qing Jiang ◽  
Yong Feng Zhao
Keyword(s):  
Diagnostic Performance ◽  
Thyroid Nodules ◽  
New Technologies ◽  
Statistical Significance ◽  
Characteristic Curve ◽  
Logistic Models ◽  
Contrast Enhanced Ultrasound ◽  
Clinical Value ◽  
Contrast Enhanced ◽  
Significant Difference

BackgroundWith the improvement of ultrasound imaging resolution and the application of various new technologies, the detection rate of thyroid nodules has increased greatly in recent years. However, there are still challenges in accurately diagnosing the nature of thyroid nodules. This study aimed to evaluate the clinical application value of the radiomics features extracted from B-mode ultrasound (B-US) images combined with contrast-enhanced ultrasound (CEUS) images in the differentiation of benign and malignant thyroid nodules by comparing the diagnostic performance of four logistic models.MethodsWe retrospectively collected and ultimately included B-US images and CEUS images of 123 nodules from 123 patients, and then extracted the corresponding radiomics features from these images respectively. Meanwhile, a senior radiologist combined the thyroid imaging reporting and data system (TI-RADS) and the enhancement pattern of the ultrasonography to make a graded diagnosis of the malignancy of these nodules. Next, based on these radiomics features and grades, logistic regression was used to help build the models (B-US radiomics model, CEUS radiomics model, B-US+CEUS radiomics model, and TI-RADS+CEUS model). Finally, the study assessed the diagnostic performance of these radiomics features with a comparison of the area under the curve (AUC) of the receiver operating characteristic curve of four logistic models for predicting the benignity or malignancy of thyroid nodules.ResultsThe AUC in the differential diagnosis of the nature of thyroid nodules was 0.791 for the B-US radiomics model, 0.766 for the CEUS radiomics model, 0.861 for the B-US+CEUS radiomics model, and 0.785 for the TI-RADS+CEUS model. Compared to the TI-RADS+CEUS model, there was no statistical significance observed in AUC between the B-US radiomics model, CEUS radiomics model, B-US+CEUS radiomics model, and TI-RADS+CEUS model (P&gt;0.05). However, a significant difference was observed between the single B-US radiomics model or CEUS radiomics model and B-US+CEUS radiomics model (P&lt;0.05).ConclusionIn our study, the B-US radiomics model, CEUS radiomics model, and B-US+CEUS radiomics model demonstrated similar performance with the TI-RADS+CEUS model of senior radiologists in diagnosing the benignity or malignancy of thyroid nodules, while the B-US+CEUS radiomics model showed better diagnostic performance than single B-US radiomics model or CEUS radiomics model. It was proved that B-US radiomics features and CEUS radiomics features are of high clinical value as the combination of the two had better diagnostic performance.

scholarly journals Diagnostic Value of Contrast-Enhanced Ultrasound Evaluation of Malignant and Benign Solitary Thyroid Nodules

2016 ◽  
Vol 70 (1) ◽  
pp. 1-6 ◽  
Author(s):  
Pēteris Priedītis ◽  
Maija Radziņa ◽  
Ilze Štrumfa ◽  
Zenons Narbuts ◽  
Arturs Ozoliņs ◽  
...  
Keyword(s):  
Contrast Enhancement ◽  
Thyroid Nodules ◽  
Fine Needle Biopsy ◽  
Diagnostic Value ◽  
Contrast Enhanced Ultrasound ◽  
Clinical Value ◽  
Additional Tool ◽  
Ultrasound Evaluation ◽  
Contrast Enhanced ◽  
Benign Nodules

Abstract The aim of the study was to investigate the diagnostic value of contrast-enhanced ultrasound (CEUS) in differentiating benign and malignant thyroid nodules. Thirty-five patients with morphologically proved thyroid nodules (17 malignant; 18 benign), underwent CEUS examination. Five enhancement patterns were evaluated: vascularisation, homogeneity, presence of peripheral rim type enhancement, wash-out rate of the contrast medium, and enhancement using microvascular imaging application. Time-intensity curves (TIC) were analysed in post-processing and defined as three types: slow versus rapid and stable versus rapid biphasic wash-out. Diagnostic value of the listed CEUS parameters was calculated. The results showed medium strength correlation between morphology (benign versus malignant nodule) and type of TIC curve rs = 0.38 (p = 0.021), as well as between mode of contrast enhancement rs = 0.39 (p = 0.022) and wash-out pattern rs =0.39 (p = 0.024). The overall pooled sensitivity of selected diagnostic parameters was 82%, specificity 57%, and accuracy 70%. Malignant nodules were characterised by iso- or hypovascular contrast enhancement and slow wash-out, while benign nodules showed hypervascular enhancement with rapid wash-out TIC curve and rim-like pattern. The CEUS patterns significantly differed between malignant and benign thyroid nodules with high diagnostic accuracy. Thus, CEUS has important clinical value as an additional tool to ultrasound and fine needle biopsy.

scholarly journals The Value of Contrast-Enhanced Ultrasound Classification in Diagnosis of Pancreatic Cystic Lesions

2019 ◽  
Vol 2019 ◽  
pp. 1-8
Author(s):  
Yixi Wang ◽  
Yanjie Wang ◽  
Zhihui Fan ◽  
Jun Shan ◽  
Kun Yan
Keyword(s):  
Diagnostic Accuracy ◽  
Diagnostic Value ◽  
Type I ◽  
Cystic Lesions ◽  
Type Ii ◽  
Contrast Enhanced Ultrasound ◽  
Type Iii ◽  
Type Iv ◽  
Contrast Enhanced ◽  
Significant Difference

Objective. To compare the consistency of contrast-enhanced ultrasound (CEUS) classification results with magnetic resonance imaging (MRI) and to investigate the diagnostic value of CEUS classification in pancreatic cystic lesions. Methods. 84 cases of pancreatic cystic lesions were enrolled in this study. According to the CEUS classification methods of previous study in our center, all the lesions were classified into four types: type I, unilocular cysts; type II, microcystic lesions; type III, macrocystic lesions; and type IV, cystic lesions with enhanced solid components. The consistency of CEUS and MRI typing results was analysed. Among the 84 cases, 45 cases had pathological results. The CEUS results were compared with the pathological results, and the diagnostic value of CEUS classification in diagnosing pancreatic cystic lesions was explored. Results. Among the 84 cases, CEUS diagnosed 8 cases of type I, 24 of type II, 8 of type III, and 45 of type IV. MRI diagnosed 10 cases of type I, 25 of type II, 7 of type III, and 43 of type IV. The classification typing results of CEUS were highly consistent with that of enhanced MRI (kappa value: 0.852). Among the 45 cases with pathological results, the diagnostic accuracy of each type was 91.1%, 95.6%, 93.3%, and 88.9%. The accuracy of CEUS and MRI in diagnosing pancreatic cystic lesions was 75.56% (34/45) and 80% (36/45), respectively. The diagnostic accuracy of CEUS had no significant difference from that of MRI (P=0.687). Conclusion. The classification results by CEUS and MRI are in excellent agreement. The classification of pancreatic cystic lesions by CEUS is significantly helpful for clinical diagnosis.

scholarly journals Diagnostic value of contrast-enhanced ultrasound in thyroid nodules with calcification

2015 ◽  
Vol 31 (3) ◽  
pp. 138-144 ◽  
Author(s):  
Jue Jiang ◽  
Xu Shang ◽  
Hua Wang ◽  
Yong-Bo Xu ◽  
Ya Gao ◽  
...  
Keyword(s):  
Thyroid Nodules ◽  
Diagnostic Value ◽  
Contrast Enhanced Ultrasound ◽  
Contrast Enhanced

Diagnostic value of contrast-enhanced ultrasound in solid thyroid nodules with and without enhancement

Endocrine ◽  
2016 ◽  
Vol 53 (2) ◽  
pp. 480-488 ◽  
Author(s):  
Qiong Wu ◽  
Yan Wang ◽  
Yi Li ◽  
Bing Hu ◽  
Zhi-Yan He
Keyword(s):  
Thyroid Nodules ◽  
Diagnostic Value ◽  
Contrast Enhanced Ultrasound ◽  
Contrast Enhanced

scholarly journals A Prospective Assessment of the Diagnostic Value of Contrast-Enhanced Ultrasound, Dynamic Computed Tomography and Magnetic Resonance Imaging for Patients with Small Liver Tumors

2019 ◽  
Vol 8 (9) ◽  
pp. 1353 ◽  
Author(s):  
Hsiao ◽  
Chen ◽  
Huang
Keyword(s):  
Magnetic Resonance Imaging ◽  
Diagnostic Performance ◽  
Liver Tumors ◽  
Diagnostic Value ◽  
Dynamic Computed Tomography ◽  
Dynamic Ct ◽  
Contrast Enhanced Ultrasound ◽  
Resonance Imaging ◽  
Contrast Enhanced ◽  
Ct And Mri

Aim: This prospective study assessed the diagnostic value of contrast-enhanced ultrasound (CEUS) using long Kupffer phase enhancement for adults with liver tumor size of less than 3 cm. Performance comparisons were also conducted with dynamic computed tomography (CT) and magnetic resonance imaging (MRI). Background: CEUS has emerged as a reliable image modality, since the development of second-generation contrast medium with long Kupffer phase enhancement. Nonetheless, dynamic CT and MRI are currently the standard imaging tools for the diagnosis of liver cancers, and the diagnostic value of CEUS for liver cancer has yet to be universally accepted. Methods: Sixty-six adult patients suspected of having liver tumors smaller than 3 cm underwent CEUS, dynamic CT, and MRI examinations independently. Subsequent tumor biopsies were used to verify the diagnostic performance of the three imaging modalities. Results: The diagnostic odds ratio (DOR, 95% CI) for hepatocellular carcinoma were as follows: CEUS (52.8, 11.4–243), CT (29.29, 7.36–116), and MRI (19.43, 5.44–69.4); for metastasis: CEUS (200, 19.1–2095), CT (24, 5.05–114), and MRI (32, 6.56–156); and all liver malignancy: CEUS (260, 12.7–5310), CT (2.57, 0.55–12.1), and MRI (5.22, 1.25–21.8). CEUS achieved the best differentiation performance. Conclusions: CEUS outperformed dynamic CT and MRI in terms of diagnostic performance when dealing with small liver tumors (<3 cm).

scholarly journals Continuous Dynamic Registration of Microvascularization of Liver Tumors with Contrast-Enhanced Ultrasound

2014 ◽  
Vol 2014 ◽  
pp. 1-5 ◽  
Author(s):  
Lukas Philipp Beyer ◽  
Benedikt Pregler ◽  
Isabel Wiesinger ◽  
Christian Stroszczynski ◽  
Philipp Wiggermann ◽  
...  
Keyword(s):  
Liver Tumors ◽  
Malignant Tumors ◽  
Regional Blood Flow ◽  
Late Phase ◽  
Diagnostic Value ◽  
Arterial Phase ◽  
Contrast Enhanced Ultrasound ◽  
Time To Peak ◽  
Contrast Enhanced ◽  
Significant Difference

Aim.To evaluate the diagnostic value of quantification of liver tumor microvascularization using contrast-enhanced ultrasound (CEUS) measured continuously from the arterial phase to the late phase (3 minutes).Material and Methods.We present a retrospective analysis of 20 patients with malignant (n=13) or benign (n=7) liver tumors. The tumors had histopathologically been proven or clearly identified using contrast-enhanced reference imaging with either 1.5 T MRI (liver specific contrast medium) or triphase CT and follow-up. CEUS was performed using a multifrequency transducer (1–5 MHz) and a bolus injection of 2.4 mL sulphur hexafluoride microbubbles. A retrospective perfusion analysis was performed to determine TTP (time-to-peak), RBV (regional blood volume), RBF (regional blood flow), and Peak.Results.Statistics revealed a significant difference (P<0.05) between benign and malignant tumors in the RBV, RBF, and Peak but not in TTP (P=0.07). Receiver operating curves (ROC) were generated for RBV, RBF, Peak, and TTP with estimated ROC areas of 0.97, 0.96, 0.98, and 0.76, respectively.Conclusion.RBV, RBF, and Peak continuously measured over a determined time period of 3 minutes could be of valuable support in differentiating malignant from benign liver tumors.

Comparison of Contrast-Enhanced Ultrasound and Gadolinium-Ethoxybenzyl-Diethylenetriamine Pentaacetic Acid-Enhanced MRI for the Diagnosis of Macroscopic Type of Hepatocellular Carcinoma

2016 ◽  
Vol 34 (6) ◽  
pp. 679-686 ◽  
Author(s):  
Takayuki Iwamoto ◽  
Yasuharu Imai ◽  
Sachiyo Kogita ◽  
Takumi Igura ◽  
Yoshiyuki Sawai ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Diagnostic Performance ◽  
Characteristic Curve ◽  
Hepatobiliary Phase ◽  
Contrast Enhanced Ultrasound ◽  
Enhanced Mri ◽  
Contrast Enhanced ◽  
Macroscopic Classification ◽  
Diethylenetriamine Pentaacetic Acid

Objective: We compared the efficacy of contrast-enhanced ultrasound sonography (CEUS) with sonazoid and gadolinium-ethoxybenzyl-diethylenetriamine pentaacetic acid (Gd-EOB-DTPA)-enhanced MRI for the assessment of macroscopic classification of nodular hepatocellular carcinoma (HCC). Methods: Seventy-seven consecutive patients with 79 surgically resected HCCs who underwent both preoperative CEUS and Gd-EOB-DTPA-enhanced MRI were enrolled in this retrospective study. Based on the macroscopic diagnosis of resected specimens, nodules were categorized into the simple nodular (SN) and non-SN type HCC. Two hepatologists independently assessed image datasets of the post-vascular phase of CEUS and hepatobiliary phase of Gd-EOB-DTPA-enhanced MRI to compare their diagnostic performance. Results: Gd-EOB-DTPA-enhanced MRI enabled the evaluation of macroscopic classification in a significantly larger number of nodules than CEUS (78/79 (98.7%) vs. 70/79 (88.6%), p < 0.05). Of 70 nodules that could be evaluated by both modalities, 41 and 29 nodules were pathologically categorized as SN and non-SN, respectively. The areas under the receiver operating characteristic curve (AUC) for non-SN did not differ between CEUS and Gd-EOB-DTPA-enhanced MRI (reader 1: 0.748 for CEUS, 0.808 for MRI; reader 2: 0.759 for CEUS, 0.787 for MRI). The AUC of combined CEUS and Gd-EOB-DTPA-enhanced MRI for SN HCC was 0.855 (reader 1) and 0.824 (reader 2), indicating higher AUC values for the combined modalities. Conclusions: The diagnostic performance for macroscopic classification of nodular HCC of CEUS was comparable with that of Gd-EOB-DTPA-enhanced MRI, although some HCCs could not be evaluated by CEUS owing to lower detectability. The combination of the 2 modalities had a more accurate diagnostic performance.

scholarly journals Application of contrast enhanced ultrasound in gallbladder lesion: is it helpful to improve the diagnostic capabilities?

2018 ◽  
Vol 20 (4) ◽  
pp. 420 ◽  
Author(s):  
Wen-Tao Kong ◽  
Hi-Yun Shen ◽  
Yu-Dong Qiu ◽  
Hao Han ◽  
Bao-Jie Wen ◽  
...  
Keyword(s):  
Diagnostic Accuracy ◽  
Diagnostic Performance ◽  
Color Doppler ◽  
Final Diagnosis ◽  
Wall Thickening ◽  
Contrast Enhanced Ultrasound ◽  
Color Doppler Flow Imaging ◽  
Imaging Characteristics ◽  
Contrast Enhanced ◽  
Significant Difference

The aim of this study is to evaluate if contrast enhanced ultrasound (CEUS) can improve the differential diagnostic performance of gallbladder (GB) lesions.Materials and methods: Forty-nine patients (18 men, 31 women; mean age, 54.8±14.4 years, range age, 22-78 years) with GB lesions (mass-forming and wall-thickened types) were enrolled in this study. All patients underwent conventional ultrasonography (US) and CEUS examination. The imaging characteristics of GB lesions were analyzed to compare the diagnostic performance of US and CEUS. The final diagnosis was obtained by histopathology.Results: There were significant differences between benign and malignant GB lesions with regards to size, shape, vascularity, the integrity and margin of GB wall and time to iso-enhancement on CEUS (p<0.05). However, no significant difference was found concerning the enhancement patterns between the two groups (p>0.05). Logistic regression analysis showed that the boundary between liver and GB wall (p=0.017) and vascularity on color Doppler flow imaging (p=0.013) were two independent predictors of malignancy. The diagnostic accuracy of US could be improved in combination with CEUS (65.3% vs 83.7%). The diagnostic accuracy of the GB wall thickening type was higher than the mass forming type.Conclusion: CEUS could improve the diagnostic performance of GB lesions, especially for wall-thickened type lesions

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