Analysis of the Influence Factors on the Differential Diagnosis Between Benign and Malignant 4-Class Thyroid Nodules by the Ratio of the Elastic Strain Rate

2020 ◽  
Vol 10 (3) ◽  
pp. 731-735
Author(s):  
Peng An ◽  
Yingjian Ye ◽  
Yuxin Ning ◽  
Wei Feng ◽  
Yang Li ◽  
...  
Keyword(s):  
Differential Diagnosis ◽  
Thyroid Gland ◽  
Strain Rate ◽  
Roc Curve ◽  
Elastic Strain ◽  
Operating Characteristic ◽  
Thyroid Nodules ◽  
Influence Factors ◽  
Factors Influencing ◽  
Surgical Operations

Objective: This study aimed to investigate the value of elastic strain rate ratio (SR) in the differential diagnosis of benign and malignant thyroid imaging reporting and data system (TI-RADS) 4 nodules under the influence of various factors. Method: This study included 180 patients with type 4 unifocal thyroid nodules diagnosed by ultrasound examination in the Xiangyang No. 1 People's Hospital from March 2016 to March 2019. All patients underwent elasticity imaging and surgical operations. The pathological results were used as the gold standard to perform logistic regression analyses and identify the factors influencing the differential diagnosis of benign and malignant thyroid nodules. Then, the receiver operating characteristic (ROC) curve was drawn. Results: The ROC curve suggested a cutoff value of 0.52 in differentiating between benign and malignant TI-RADS 4 nodules using the SR value. The nodule size, calcification, border, and thyroid gland with diffuse lesions were factors influencing the differential diagnosis of benign and malignant TI-RADS 4 nodules with the SR value. SR had a high accuracy identifying benign and malignant TI-RADS 4 nodules with a diameter of less than 0.8 cm (but >0.4 cm), no or granular calcification, nodules with blurred borders, and no thyroid gland with diffuse lesions. Conclusion: The diagnostic accuracy was improved by combining the two-dimensional ultrasound with SR determination in the differential diagnosis of benign or malignant TI-RADS 4 nodules.

scholarly journals Ultrasonic elastography and conventional ultrasound in the diagnosis of thyroid micro-nodules

2019 ◽  
Vol 35 (6) ◽  
Author(s):  
Jinming Wang ◽  
Wenbing Wei ◽  
Rui Guo
Keyword(s):  
Differential Diagnosis ◽  
Roc Curve ◽  
Thyroid Nodules ◽  
Ultrasound Elastography ◽  
Surgical Pathology ◽  
Maximum Diameter ◽  
Clinical Value ◽  
Conventional Ultrasound ◽  
Missed Diagnosis ◽  
The Difference

Objective: To investigate the clinical value of conventional ultrasound, ultrasound elastography and conventional ultrasound combined with ultrasound elastography in differential diagnosis of benign and malignant thyroid micro-nodules. Methods: Eighty-six patients who were found with thyroid micro-nodules with the maximum diameter no more than 10 mm in the physical examination in our hospital from June 2015 to December 2017 were selected, and 102 nodules were included. All patients were confirmed with thyroid micro-nodules by puncture or surgical pathology and underwent conventional ultrasound and ultrasound elastography. Taking the surgical pathological results as a control, the value of conventional ultrasound, ultrasound elastography and conventional ultrasound combined with ultrasound elastography in differential diagnosis of benign and malignant thyroid micro-nodules were compared. A receiver operating characteristic (ROC) curve was drawn, and the area under the ROC curve was calculated. Results: One hundred and two thyroid nodules were detected by surgical pathology, including 75 benign nodules (73.53%) and 27 malignant nodules (26.47%). The sensitivity and diagnostic accordance rate of ultrasound elastography were significantly higher than those of conventional ultrasound in the diagnosis of thyroid microcarcinoma, and the missed diagnosis rate of ultrasound elastography was significantly lower than that of conventional ultrasound; the difference was statistically significant (P<0.05). However, the difference between the two methods was not statistically significant in terms of diagnostic specificity and misdiagnosis rate (P>0.05). The areas under the ROC curve in the diagnosis of benign and malignant thyroid nodules by conventional ultrasound and ultrasound elastography were 0.735 and 0.743 respectively. Conclusion: Conventional ultrasound can be used as a routine examination technique in differential diagnosis of benign and malignant thyroid nodules, while ultrasound elastography can improve the sensitivity and diagnostic rate in the diagnosis of thyroid micro carcinoma. It can help to reduce the clinical missed diagnosis, which also can be be used as an effective supplement for conventional ultrasound. doi: https://doi.org/10.12669/pjms.35.6.777 How to cite this:Wang J, Wei W, Guo R. Ultrasonic elastography and conventional ultrasound in the diagnosis of thyroid micro-nodules. Pak J Med Sci. 2019;35(6):1526-1531. doi: https://doi.org/10.12669/pjms.35.6.777 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

scholarly journals Efficacy of Differential Diagnosis of Thyroid Nodules by Shear Wave Elastography, the Stiffness Map

2021 ◽  
Author(s):  
Myung Hi Yoo ◽  
Hye Jeong Kim ◽  
In Ho Choi ◽  
Suyeon Park ◽  
Sumi Yun ◽  
...  
Keyword(s):  
Differential Diagnosis ◽  
Shear Wave ◽  
Roc Curve ◽  
Thyroid Nodules ◽  
Shear Wave Elastography ◽  
Curve Analysis ◽  
Follicular Neoplasm ◽  
Roc Curve Analysis ◽  
Cutoff Value ◽  
Benign Pathology

Abstract Background Fine-needle aspiration is the gold standard, but malignancy rate of the indeterminate cytology is reported as 20-50 %. We aimed to evaluate the efficacy of shear wave elastography (SWE) added to ultrasonogram in the differential diagnosis of thyroid nodules. Methods We retrospectively reviewed the medical records of 258 consecutive patients. Thyroid nodules were divided in to 4 categoies according to maximum elasticity (EMax) and nodule depth/width (D/W) ratio; Category 1 (EMax ≥42.6 kPa & D/W&lt;0.9), Category 2 (EMax &lt;42.6 kPa & D/W&lt;0.9 ), Category 3 (EMax ≥42.6 kPa & D/W≥ 0.9) and Category 4 (EMax&lt;46.2 kPa & D/W≥ 0.9 ). The cutoff value of EMax was set using ROC curve analysis to predict nodular hyperplasia (NH) from follicular neoplasm (FN). Cutoff value ​​for nodule D/W ratio was set using ROC curve analysis for malignancy. Results NH was the most prevalent pathology group in category 1, FN in category 2 and PTC in category 3. The category 3 demonstrated the highest rate of malignancy (81.8%) and had 55.4% sensitivity and 90% specificity for predicting malignancy. When assessing the benign pathology of NH in follicular patterned lesion, category 1 demonstrated the highest NH prevalence of 88.9% (34/37) and had 73.9% sensitivity and 85.0% specificity. Conclusion The performance for malignancy was highest in category 3 and predictive ability for benign pathology of NH in follicular lesion was highest in category 1. So the information of EMax and nodule D/W ratio was useful to predict the pathology of thyroid nodules

scholarly journals Efficacy of Differential Diagnosis of Thyroid Nodules by Shear Wave Elastography, the Stiffness Map

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. A860-A861
Author(s):  
Myung Hi Yoo ◽  
Hye Jeong Kim ◽  
In Ho Choi ◽  
Suyeon Park ◽  
Sumi Yun ◽  
...  
Keyword(s):  
Differential Diagnosis ◽  
Shear Wave ◽  
Roc Curve ◽  
Thyroid Nodules ◽  
Shear Wave Elastography ◽  
Needle Aspiration ◽  
Curve Analysis ◽  
Follicular Neoplasm ◽  
Roc Curve Analysis ◽  
Cutoff Value

Abstract Background: Fine-needle aspiration (FNA) is the first step in the differential diagnosis of thyroid nodules. However, malignancy rate of the indeterminate FNA is reported as 20-50 %. We aimed to evaluate the efficacy of shear wave elastography (SWE), the map of stiffness in the differential diagnosis of the histopathology of thyroid nodules. Methods: We retrospectively reviewed the medical records of 258 consecutive patients who visited the thyroid clinic for thyroid nodules and who underwent SWE before ultrasound-guided FNA and/or core-needle biopsy. We analyzed the EI using the total nodular region of interest method by the Q-Box Trace program. Thyroid nodules were divided in to 4 categoies according to maximum elasticity (EMax) and nodule depth/width (D/W) ratio; Category 1 (EMax ≥42.6 kPa & D/W&lt;0.9), Category 2 (EMax &lt;42.6 kPa & D/W&lt;0.9), Category 3 (EMax ≥42.6 kPa & D/W≥ 0.9) and Category 4 (EMax&lt;46.2 kPa & D/W≥ 0.9). The cutoff value of EMax was set using ROC curve analysis to predict follicular neoplasm (FN) from nodular hyperplasia (NH). Cutoff value ​​for nodule D/W ratio was set using ROC curve analysis to differentiate malignant nodule. Results: FN showed the lowest EMax among all pathologies and lower EMax than NH (p&lt;0.05). FN was distributed mostly in the category 2 (70%) and NH was distributed mainly in the category 1 (73.9%). CLT belonged mostly to the category 1 (57.1%). PTC belonged in majority to the category 3 (58.9%) and the rest.to the category 1 (25%). So NH was the most frequent pathology group in category 1.FN was the most frequent pathology group in the category 2 and PTC was the most frequent pathology group in the category 3. Conclusion: SWE showed characteristic patterns of various pathology groups reflecting the degree of fibrosis and the information of EMax and nodule depth/width (D/W) ratio determining the category was useful to predict the pathology of thyroid nodules along with the advantage of noninvasiveness.

Assessment of a panel of miRNAs in serum and pleural fluid for the differential diagnosis of malignant and benign pleural effusion

2021 ◽  
pp. 1-11
Author(s):  
Li-Rong Zhu ◽  
Rong-Xia Yuan ◽  
Xian-Bin Xia ◽  
Yi Wang ◽  
Yu-Min Zhu ◽  
...  
Keyword(s):  
Differential Diagnosis ◽  
Pleural Effusion ◽  
Pleural Fluid ◽  
Roc Curve ◽  
Operating Characteristic ◽  
Aberrant Expression ◽  
Qrt Pcr ◽  
Individual Mirnas ◽  
Tuberculous Pleurisy ◽  
Benign Pleural Effusion

BACKGROUND: Differential diagnosis between malignant pleural effusion (MPE) and benign pleural effusion (BPE) remains a clinical challenge. OBJECTIVE: The aim of the study is to assess the efficacy of the serum and pleural fluid (PF) miRNA panels in distinguishing MPE from BPE. METHODS: Fourteen candidate miRNAs which were shown aberrant expression in lung cancer based on previous studies were tested by quantitative real-time PCR (qRT-PCR) in 20 MPE patients and 20 BPE patients. Significantly aberrantly expressed miRNAs were further assessed by qRT-PCR in all patients enrolled in this study. A receiver operating characteristic (ROC) curve was constructed, and the area under the ROC curve (AUC) was calculated to evaluated the diagnostic performance of the miRNAs. RESULTS: miR-21, miR-29c and miR-182 were found to be significantly aberrantly expressed in the serum and PF of MPE patients. The AUCs for the combination of miR-21, miR-29c and miR-182 in serum and PF were 0.832 and 0.89 respectively in distinguishing MPE from infection-associated PE including tuberculous pleurisy and parapneumonia PE, and 0.866 and 0.919 respectively for differentiating MPE from heart failure-associated PE, which were superior to AUC of each individual miRNAs. CONCLUSIONS: miR-21, miR-29c and miR-182 in serum and PF could be useful biomarkers for MPE of diagnosis.

Compensated 131I-therapy of solitary autonomous thyroid nodules: effect on thyroid size and early hypothyroidism

1986 ◽  
Vol 113 (2) ◽  
pp. 226-232 ◽  
Author(s):  
Laszlo Hegedüs ◽  
Dagmar Veiergang ◽  
Steen Karstrup ◽  
Jens Mølholm Hansen
Keyword(s):  
Thyroid Gland ◽  
Thyroid Function ◽  
Thyroid Nodules ◽  
Thyroid Volume ◽  
131I Therapy ◽  
Important Place ◽  
Gland Volume ◽  
Thyroid Gland Volume ◽  
One Year ◽  
Hyperthyroid Patients

Abstract. Thyroid function and thyroid gland volume, ultrasonically determined, were investigated in 27 hyperthyroid patients with solitary autonomous thyroid nodules before and during one year after 131I-treatment. Total thyroid volume decreased gradually from 40.9 ± 3.5 ml (mean ± sem) before treatment to 23.9 ± 1.8 ml (P < 0.001) at 3 months after 131I-treatment. No further change was observed. All but two patients received only one dose of 131I, and in spite of a significant decrease also of the non-adenoma side of the gland, none became hypothyroid. We conclude that 131I-therapy has an important place in the treatment of solitary autonomous thyroid nodules since all our patients became euthyroid within 3 months, only 2 of 27 patients needed more than one dose of 131I, no cases of hypothyroidism occurred, and thyroid volume was substantially decreased.

scholarly journals Statistical Assessment of Discrimination Capabilities of a Fractional Calculus Based Image Watermarking System for Gaussian Watermarks

Entropy ◽  
2021 ◽  
Vol 23 (2) ◽  
pp. 255
Author(s):  
Mario Gonzalez-Lee ◽  
Hector Vazquez-Leal ◽  
Luis J. Morales-Mendoza ◽  
Mariko Nakano-Miyatake ◽  
Hector Perez-Meana ◽  
...  
Keyword(s):  
Fractional Calculus ◽  
Roc Curve ◽  
Gaussian Noise ◽  
False Positive ◽  
Operating Characteristic ◽  
Image Watermarking ◽  
Area Under The Curve ◽  
Statistical Assessment ◽  
Watermarking Scheme ◽  
Fractional Equation

In this paper, we explore the advantages of a fractional calculus based watermarking system for detecting Gaussian watermarks. To reach this goal, we selected a typical watermarking scheme and replaced the detection equation set by another set of equations derived from fractional calculus principles; then, we carried out a statistical assessment of the performance of both schemes by analyzing the Receiver Operating Characteristic (ROC) curve and the False Positive Percentage (FPP) when they are used to detect Gaussian watermarks. The results show that the ROC of a fractional equation based scheme has 48.3% more Area Under the Curve (AUC) and a False Positives Percentage median of 0.2% whilst the selected typical watermarking scheme has 3%. In addition, the experimental results suggest that the target applications of fractional schemes for detecting Gaussian watermarks are as a semi-fragile image watermarking systems robust to Gaussian noise.

scholarly journals Presepsin values and prognostic nutritional index predict mortality in intensive care unit patients with sepsis: a pilot study

2021 ◽  
Vol 14 (1) ◽  
Author(s):  
Yuichiro Shimoyama ◽  
Osamu Umegaki ◽  
Noriko Kadono ◽  
Toshiaki Minami
Keyword(s):  
Multivariate Analysis ◽  
Roc Curve ◽  
Operating Characteristic ◽  
Prognostic Nutritional Index ◽  
Early Mortality ◽  
Curve Analysis ◽  
Rank Test ◽  
Roc Curve Analysis ◽  
Log Rank Test ◽  
Nutritional Index

Abstract Objective Sepsis is a major cause of mortality for critically ill patients. This study aimed to determine whether presepsin values can predict mortality in patients with sepsis. Results Receiver operating characteristic (ROC) curve analysis, Log-rank test, and multivariate analysis identified presepsin values and Prognostic Nutritional Index as predictors of mortality in sepsis patients. Presepsin value on Day 1 was a predictor of early mortality, i.e., death within 7 days of ICU admission; ROC curve analysis revealed an AUC of 0.84, sensitivity of 89%, and specificity of 77%; and multivariate analysis showed an OR of 1.0007, with a 95%CI of 1.0001–1.0013 (p = 0.0320).

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