ARFI ELASTOGRAPHY IN THE DIAGNOSIS OF THYROID NODULES

Objective: To describe the sonography characteritics of the thyroid nodules using Acoutic Radiation Force Impulse Imaging (ARFI), and to evaluate the role of ARFI technique combination with 2D Ultrasound in diagnosing thyroid nodules. Methods: 2D Ultrasound and ARFI Elatography were caried out in 63 patients who have thyroid nodules. Images of 2D Ultrasound were classified according to Russ G. (French TIRADS). ARFI Elastography was performed by 2 techniques: “ Virtual Touch tissue imaging” in order to image of strain distribution and “Virtual Touch tissue quantification Imaging” to measure the shear wave velocity (SWV) in the tissue. Strain distribution was classified according to Xu’s VTI grading method. SWV was measured in the solid portions or suspicious regions of a nodule, avoiding cystic portions or calcifications. According to the results of pathology, we determine and compare the value between 2D Ultrasound plus ARFI elastography and 2D Ultrasound alone. Results: 63 patients with thyroid nodules: 14 malignant nodules and 49 benign nodules. The mean SWV of benign nodules were 1.78±1.22 m/s, the mean SWV of malignant nodules were 7.09±2.87 m/s. The best cut-off point for SWV was 2.4 m/s. For VTI, grade IV was the best cut-off value in differentiation of benign and malignant thyroid nodules. 2D Ultrasound plus VTI and 2D Ultrasound plus VTQ: Se 100% and 100%, Sp 87.8% and 85.7%, PPV 70% and 66.7%, NPV 100% and 100%, Acc 90.5 % and 88.9% (K=0.761 and K=0.727). Conclusions: In addition to the morphologic characteristics of thyroid nodules, ARFI provides information about lesion’s tissue elasticity, which can be useful tool in diferential diagnosis of thyroid nodules. Key words: Acoustic Radiation Force Impulse Imaging (ARFI), thyroid nodules

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Efficacy of acoustic radiation force impulse elastography in differentiation of benign and malignant lymph nodes

Asian Journal of Oncology ◽

10.4103/asjo.asjo_48_17 ◽

2017 ◽

Vol 03 (02) ◽

pp. 106-110 ◽

Cited By ~ 1

Author(s):

Rashmi Sudhir ◽

M. V. T. Krishna Mohan ◽

Bogala Shilpa ◽

Veeraiah K. Chaudhary

Keyword(s):

Lymph Nodes ◽

Operating Characteristic ◽

Acoustic Radiation ◽

Radiation Force ◽

Acoustic Radiation Force ◽

Acoustic Radiation Force Impulse ◽

Tissue Imaging ◽

Arfi Elastography ◽

The Mean ◽

Malignant Lymph Nodes

Abstract Aims and Objectives: Aim of this study was to assess the clinical usefulness of Acoustic Radiation Force Impulse (ARFI) elastography imaging in differentiating benign and malignant/metastatic superficial nodes. Methods and Materials: ARFI elastography (Siemens Medical Solutions, Mountain View, CA) using Virtual touch Tissue Imaging (VTI) technique was performed and Shear wave velocity (m/sec) was measured in 85 patients (mean age, 49 years; range, 16–72 years) with 126 lymph nodes (96 axillary, 21 cervical and 9 inguinal nodes) which were biopsied and histo-pathologically correlated. Results: Of 126 nodes, 71 were benign (64 reactive and 7 koch's) and 55 were malignant (40 metastases and 15 lymphoma). The mean ARFI value of malignant nodes ±SD (4.42 ± 2.60) were significantly higher than the benign nodes (1.76 ± 0.44), with P <0.001. With the use of Receiver Operating Characteristic (ROC) curve, the cut off SWV was estimated to be 2.45m/s with sensitivity of 83.6%, specificity of 91%, and accuracy of 93.7 % while the conventional US based short axis diameter (SAD) measurement with cut off value of 10mm, showed the sensitivity of 62 %, specificity of 87% and accuracy of 87%. Conclusion: Acoustic radiation force impulse elastography is feasible for superficial lymph nodes and provides quantitative elasticity measurements, which may complement B-mode ultrasound and potentially improve the differentiation of benign and malignant/metastatic lymph nodes.

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ARFI ELASTOGRAPHY IN THE DIAGNOSIS OF FOCAL BREAST LESIONS

Journal of Medicine and Pharmacy ◽

10.34071/jmp.2017.1.3 ◽

2017 ◽

pp. 23-29

Author(s):

Thi Kim Yen Vo ◽

Phuoc Bao Quan Nguyen ◽

Thanh Thao Nguyen

Keyword(s):

Malignant Tumors ◽

Acoustic Radiation ◽

Radiation Force ◽

Acoustic Radiation Force ◽

Acoustic Radiation Force Impulse ◽

Benign Tumors ◽

Breast Lesions ◽

Focal Lesions ◽

Arfi Elastography ◽

2D Ultrasound

Objective: To describe the sonographic characteristics of the focal breasst lesions using Acoustic Radiation Force Impulse Imaging (ARFI), and to evaluate the role of ARFI technique in combination with 2D Ultrasound in diagnosing focal breast lesions. Methods: 2D Ultrasound and ARFI Elastography were caried out in 52 patients who have focal lesions of breast. Images of 2D Ultrasound were classified according to ACR 2013. ARFI Elastography was performed by 2 techniques: “Virtual Touch HD tissue imaging” in order to image of strain distribution and “Virtual Touch HD Tissue quantification imaging” to measure the shear wave velocity (SWV) in the tissue. Strain distribution was classified according to Ako Itoh scale. SWV were measured in 4 positions: internal the lesion (SWVi), boundary zone (SWVb), glandular tissue and fatty tissue next to lesion (SWg and SWf). According to the results of pathology, we determine and compare the value between 2D Ultrasound plus ARFI elastography and 2D Ultrasound alone. Results: 52 patients with breast focal lesions: 22 malignant tumors and 30 benign tumors. Mean Ako Itoh scale of benign tumors were 2.19 ± 1.13 and malignant tumors were 4.72 ± 0.55; the cut-off value was between E3 và E4. SWVi, SWVb, SWVf, SWVg of benign tumors were lower than malignant tumors with cut-off values were 3.32 m/s; 6.01m/s; 1.08m/s; 2.37m/s, respectively. 2D Ultrasound plus ARFI Elastography: Se 100%, Sp 90%, PPV 88%, NPV 100%, Acc 94.2% (p<0.001, K = 0.884). Conclutions: In addition to the morphologic characteristics of breast lesions, ARFI provides information about lesion’s tissue elasticity, which can be a useful tool to differentitate malignant lesions from benign ones. Key words: elastography, focal breast lesions, Acoustic Radiation Force Impulse Imaging

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Diagnostic Value of Acoustic Radiation Force Impulse Quantification in the Differentiation of Benign and Malignant Thyroid Nodules

Ultrasonic Imaging ◽

10.1177/0161734617706170 ◽

2017 ◽

Vol 39 (5) ◽

pp. 326-336 ◽

Cited By ~ 3

Author(s):

Niraj Nirmal Pandey ◽

Gaurav Shanker Pradhan ◽

Alpana Manchanda ◽

Anju Garg

Keyword(s):

Thyroid Nodules ◽

Acoustic Radiation ◽

Radiation Force ◽

Acoustic Radiation Force ◽

Ultrasound Elastography ◽

Acoustic Radiation Force Impulse ◽

Shear Wave Speed ◽

The Mean ◽

Benign Thyroid Nodules ◽

Benign Thyroid

The objective of this study was to evaluate the role of ultrasound elastography using acoustic radiation force impulse (ARFI) quantification in characterizing and differentiating malignant versus benign thyroid nodules. A total of 40 thyroid nodules were evaluated with conventional sonography and ultrasound elastography using ARFI quantification. The final diagnosis was obtained from histologic findings. A total of 14 malignant and 26 benign nodules were diagnosed on the basis of histologic examination. Majority of the malignant thyroid nodules demonstrated presence of intranodular vascular flow, hypoechoic echotexture, absent halo, irregular margins and microcalcifications. However, a considerable overlap was noted in the sonographic features of malignant and benign thyroid nodules. On ARFI quantification, the mean shear wave speed (SWS) values ( M ± SD) of malignant and benign thyroid nodules were 3.131 ± 0.921 m/s and 1.691 ± 0.513 m/s, respectively. A significant difference was observed between the mean SWS values of malignant thyroid nodules and benign thyroid nodules ( p < 0.0001). Applying a cutoff value of 2.53 m/s, the sensitivity, specificity, and the area under the receiver operating characteristic curve for the differentiation were 85.71%, 96.15%, and 0.922, respectively. ARFI quantification is a promising elastography technique that provides quantitative information about tissue stiffness. It provides additional information and complements sonography as an effective diagnostic tool in characterizing and differentiating benign from malignant thyroid nodules.

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Comparative Efficacy of Ultrasonography and Acoustic Radiation Force Impulse (ARFI) Elastography in Prediction of Malignancy in Thyroid Nodules

Journal of Diagnostic Medical Sonography ◽

10.1177/8756479320931354 ◽

2020 ◽

Vol 36 (5) ◽

pp. 433-443

Author(s):

Sarika Goel ◽

Ankur Malhotra ◽

Arjit Agarwal ◽

Shruti Chandak ◽

Ashutosh Kumar ◽

...

Keyword(s):

Thyroid Nodules ◽

Acoustic Radiation ◽

Radiation Force ◽

Acoustic Radiation Force ◽

Acoustic Radiation Force Impulse ◽

Receiver Operating Characteristic Curves ◽

Sonographic Patterns ◽

Arfi Elastography ◽

Arfi Imaging ◽

Better Than

Objective: The incidence of malignancy in thyroid nodules is infrequent, but this trend may be reversing. The present study was conducted to emphasize the diagnostic accuracy of acoustic radiation force impulse (ARFI) imaging, in addition to conventional gray-scale ultrasonography (US), for differentiating benign and malignant thyroid nodules. Methods: A total of 141 patients with thyroid nodules (≥10 mm) were included in the study and were evaluated with US, Doppler, and ARFI elastography using Siemens S2000 Acuson ultrasound equipment. Results: The sonographic patterns most predictive and indicative of malignancy included irregular margins and presence of microcalcifications. The Doppler findings in isolation were not extremely sensitive in the detection of malignancy. The shear wave velocity cutoff value on ARFI imaging using receiver operating characteristic curves for differentiation of benign and malignant nodules were noted at 2.87 m/s. ARFI imaging performed better than US and Doppler with sensitivity of 75%, specificity of 96%, and accuracy of 94%. Conclusion: ARFI elastography could be utilized as a reliable initial screening test for detection of malignancy in thyroid nodules.

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Role of color-coded virtual touch tissue imaging in suspected thyroid nodules

Technology and Health Care ◽

10.3233/thc-213156 ◽

2021 ◽

pp. 1-10

Author(s):

Kai-Mei Lian ◽

Teng Lin

Keyword(s):

Regression Model ◽

Thyroid Nodules ◽

Acoustic Radiation ◽

Radiation Force ◽

Acoustic Radiation Force Impulse ◽

Tissue Imaging ◽

Multivariate Logistic Regression Model ◽

The Us ◽

The Difference ◽

Virtual Touch Tissue Imaging

BACKGROUND: Conventional ultrasound (US) is the most widely used imaging test for thyroid nodule surveillance. OBJECTIVE: We used the color-coded virtual touch tissue imaging (VTI) in the Acoustic Radiation Force Impulse (ARFI) technique to assess the hardness of the American College of Radiology (ACR) Thyroid Imaging Reporting and Data System (TI-RADS) TR3-5 nodules. The ability of color-coded VTI (CV) to discriminate between benign and malignant nodules was investigated. METHODS: In this retrospective study, US and CV were performed on 211 TR3-5 thyroid lesions in 181 consecutive patients. All nodules were operated on to obtain pathological results. A multivariate logistic regression model was chosen to integrate the data obtained from the US and CV. RESULTS: The area under the receiver operating characteristic (ROC) curve for the model was 0.945 (95% CI, 0.914 to 0.976). The cutoff value of predictive probability for diagnosing malignant thyroid nodules was 10.64%, the sensitivity was 94.43%, and the specificity was 83.12%. Through comparing with US and CV, respectively, it had been observed that the regression model had the best performance (all P< 0.001). However, when the US was compared with CV, the difference was not significant (P= 0.3304). CONCLUSIONS: A combination of US and CV should be recommended for suspected malignant thyroid nodules in clinical practice.

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A dilemma at gray scale thyroid ultrasound: microcalcification or not? Differentiation with Acoustic Radiation Force Impulse Imaging–Virtual Touch Imaging.

Medical Ultrasonography ◽

10.11152/mu-872 ◽

2016 ◽

Vol 18 (4) ◽

pp. 452 ◽

Cited By ~ 4

Author(s):

Duzgun Yildirim ◽

Cesur Samanci ◽

Fethi Emre Ustabasioglu ◽

Deniz Alis ◽

Bulent Colakoglu ◽

...

Keyword(s):

Interobserver Agreement ◽

Thyroid Nodules ◽

Acoustic Radiation ◽

Radiation Force ◽

Acoustic Radiation Force ◽

Acoustic Radiation Force Impulse ◽

Gray Scale ◽

Displacement Maps ◽

Benign Nodules ◽

Echogenic Foci

Aims: To evaluate the capacity of virtual touch imaging (VTI) of the acoustic radiation force impulse (ARFI) techniquein the differential diagnosis of micro-echogenicities in thyroid nodules. Material and methods: The study comprised 28patients. Gray scale and ARFI displacement maps were used during ultrasound examination.In the same session, fine needleaspiration biopsy (FNAB) samples were obtained from the dominant nodule hav-ing micro-echogenicities. Two radiologists blinded to the FNAB results and clinical data of the patients evaluated these images and rated ARFI echogenicities according to the degree of shining points on the displacement maps and classified them as isohypoechogenic, isohyperechogenic, and obvious hyperechogenic. To differentiate between benignancy and malignancy, “a new sign” was defined as follows: in the ARFI maps obtained by VTI, iso-echogenic or hyper-echogenic appearance of micro-echogenic foci was evaluated as benignancy and hypo-echogenic appearance of micro-echogenic foci was evaluated as malignancy. Results: The FNAB results indicated 14 cases and benign nodules in the other 14 cases. Interobserver agreement between the two radiologists was highly significant for the classification of the micro-echogenic foci (Kappa=0.659, p<0.001). When we reclassified the hyperechoic and isohyperechoic foci as “benign” and isohypoechoic foci as “malignant”, the interobserver agreement between the two radiologists increased (Kappa=0.772, p<0.001). The evaluation of the first and second radiologists were highly concordant with the gold standard pathology results (Kappa=0.786, p<0.001 and Kappa=0.714, p<0.001, respectively). Conclusions: ARFI method with specific VTI features could be a very useful tool in the differentiation of malignant microcalcifications in thyroid nodules.

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