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Hoshi M, Jikuzono T, Suzuki S, Ishibashi O, Kawamoto Y, Kure S, Kawamoto M, Ohashi R, Sugitani I. Use of Ultrasonographic Shear Wave Measurements to Diagnose Thyroid Metastasis from Breast Carcinoma. J NIPPON MED SCH 2023; 90:398-403. [PMID: 35644558 DOI: 10.1272/jnms.jnms.2023_90-501] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
A metastatic thyroid tumor (MTT) arising from breast carcinoma (BC) is rare and sometimes difficult to diagnose. We present a case of MTT from BC; we suspected anaplastic thyroid carcinoma at initial presentation. The patient was a 58-year-old female with a hard nodule in the right anterior neck and a history of breast cancer. Computed tomography indicated tumors on both thyroid lobes, and ultrasonography (US) with shear wave measurement (SWM) showed malignant features. We performed fine needle aspiration cytology (FNAC), the results of which led us to strongly suspect MTT from BC. The surgically resected specimen was evaluated histopathologically, including by immunohistochemistry (IHC), and the diagnosis was confirmed. In addition to FNAC and IHC, SWM is useful to diagnose MTT from BC.
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Affiliation(s)
- Masae Hoshi
- Department of Endocrine Surgery, Kanaji Thyroid Hospital
| | | | | | - Osamu Ishibashi
- Department of Endocrine Surgery, Nippon Medical School
- Laboratory of Biological Macromolecules, Department of Applied Life Sciences, Graduate School of Life & Environmental Sciences, Osaka Prefecture University
| | - Yoko Kawamoto
- Department of Integrated Diagnostic Pathology, Nippon Medical School
| | - Shoko Kure
- Department of Integrated Diagnostic Pathology, Nippon Medical School
| | - Masashi Kawamoto
- Department of Diagnostic Pathology, Shonan Fujisawa Tokushukai Hospital
| | - Ryuji Ohashi
- Department of Integrated Diagnostic Pathology, Nippon Medical School
| | - Iwao Sugitani
- Department of Endocrine Surgery, Nippon Medical School
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Lee J, Yoon SK, Cho JH, Kwon HJ, Kim DW, Lee JW. Variability of Transrectal Shear Wave Elastography in a Phantom Model. JOURNAL OF THE KOREAN SOCIETY OF RADIOLOGY 2023; 84:1110-1122. [PMID: 37869125 PMCID: PMC10585080 DOI: 10.3348/jksr.2023.0051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Revised: 06/18/2023] [Accepted: 06/30/2023] [Indexed: 10/24/2023]
Abstract
Purpose This study aimed to assess the variability of transrectal shear wave elastography (SWE) using a designed phantom. Materials and Methods In a phantom, the SWE values were examined by two radiologists using agarose and emulsion silicone of different sizes (1, 2, and 3 cm) and shapes (round, cubic) at three depths (1, 2, and 3 cm), two region of interest (ROI) and locations (central, peripheral) using two ultrasound machines (A, B from different vendors). Variability was evaluated using the coefficient of variation (CV). Results The CVs decreased with increasing phantom size. Significant changes in SWE values included; agarose phantom at 3 cm depth (p < 0.001; machine A), 1 cm depth (p = 0.01; machine B), emulsion silicone at 2 cm depth (p = 0.047, p = 0.020; both machines). The CVs increased with increasing depth. Significant changes in SWE values included; 1 cm agarose (p = 0.037, p = 0.021; both machines) and 2 cm agarose phantom (p = 0.047; machine A). Significant differences in SWE values were observed between the shapes for emulsion silicone phantom (p = 0.032; machines A) and between ROI locations on machine B (p ≤ 0.001). The SWE values differed significantly between the two machines (p < 0.05). The intra-/inter-operator agreements were excellent (intraclass correlation coefficient > 0.9). Conclusion The phantom size, depth, and different machines affected the variability of transrectal SWE.
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Hu L, He NA, Xie L, Ye X, Liu X, Pei C, Zhou HC, Zhong W. Evaluation of the Perinodular Stiffness Potentially Predicts the Malignancy of Thyroid Nodules. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2020; 39:2183-2193. [PMID: 32412124 DOI: 10.1002/jum.15329] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/01/2020] [Revised: 04/17/2020] [Accepted: 04/21/2020] [Indexed: 06/11/2023]
Abstract
OBJECTIVES To evaluate the surrounding tissue stiffness measured by sound touch elastography for differential diagnosis of thyroid nodules (TNs). METHODS Thirty-nine benign and 90 malignant TNs were included in this study. The conventional ultrasound features, the maximum Young modulus value of the stiffness of the TNs (recorded as E), and the stiffness of the 0.5-, 1.0-, 1.5-, and 2.0-mm perinodular regions of the TNs (recorded as Eshell0.5 , Eshell1.0 , Eshell1.5 , and Eshell2.0 , respectively) were prospectively analyzed and compared to histopathologic results. The abundance of collagen fibers at various widths in the perinodular regions of the TNs was evaluated by Masson staining and ImageJ software (National Institutes of Health, Bethesda, MD). The fibrous structures in the perinodular regions of the TNs were classified. RESULTS The various Eshell values of malignant TNs were significantly higher than those of benign TNs (P < .001 for all). Eshell0.5 correlated highly with E in the malignant TNs and in all samples (r = 0.722 and 0.772; P < .001 for both). Eshell2 yielded the highest area under the receiving operating characteristic curve value (0.96) for the differential diagnosis of TNs. The abundance of collagen fibers in the 2-mm perinodular region of the TNs was closely correlated with Eshell2 in the malignant TNs and in all samples (r =0.729 and 0.867; P < .001). The Eshell2 values for different levels of disorder of the tissue surrounding TNs were significantly different (P < .01 for all). CONCLUSIONS Perinodular stiffness measured by sound touch elastography improved the diagnostic accuracy in TNs.
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Affiliation(s)
- Lei Hu
- Department of Ultrasound, The First Affiliated Hospital of the University of Science and Technology of China, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China
| | - Nian An He
- Department of Ultrasound, The First Affiliated Hospital of the University of Science and Technology of China, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China
| | - Li Xie
- Department of Ultrasound, The First Affiliated Hospital of the University of Science and Technology of China, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China
| | - Xianjun Ye
- Department of Ultrasound, The First Affiliated Hospital of the University of Science and Technology of China, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China
| | - Xiao Liu
- Department of Ultrasound, The First Affiliated Hospital of the University of Science and Technology of China, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China
| | - Chong Pei
- Department of Respiratory and Critical Care Medicine, The First People's Hospital of Hefei City, Third Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Hang Cheng Zhou
- Department of Pathology, The First Affiliated Hospital of the University of Science and Technology of China, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China
| | - Wen Zhong
- Department of Pathology, The First Affiliated Hospital of the University of Science and Technology of China, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China
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Cunha GB, Marino LCI, Yamaya A, Kochi C, Monte O, Longui CA, Cury AN, Fleury EDFC. Elastography for the evaluation of thyroid nodules in pediatric patients. Radiol Bras 2019; 52:141-147. [PMID: 31210685 PMCID: PMC6561376 DOI: 10.1590/0100-3984.2018.0034] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Objective To evaluate the usefulness of elastography (using manual compression) as an
additional diagnostic tool for children and adolescents with thyroid
nodules. Materials and Methods This was a prospective study conducted between September 2012 and August 2013
at a hospital in Brazil. We performed elastography, ultrasound, and
fine-needle aspiration biopsy in 32 patients between 6 and 18 years of age
who had, in total, 38 thyroid nodules. Results The elastography findings correlated with the histopathological diagnosis in
78.5% of cases. In three patients, an unnecessary thyroidectomy could have
been avoided if the elastography results had been prioritized. Only one
malignant thyroid nodule was found to show high elasticity. Conclusion Our results suggest that high elasticity of a nodule on elastography is
associated with a low risk of thyroid cancer. If further confirmed in other
studies, elastography may prove useful as a complementary test for screening
thyroid nodules in children.
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Affiliation(s)
| | | | - André Yamaya
- Irmandade da Santa Casa de Misericórdia de São Paulo, São Paulo, SP, Brazil
| | - Cristiane Kochi
- Irmandade da Santa Casa de Misericórdia de São Paulo, São Paulo, SP, Brazil
| | - Osmar Monte
- Irmandade da Santa Casa de Misericórdia de São Paulo, São Paulo, SP, Brazil
| | | | - Adriano Namo Cury
- Irmandade da Santa Casa de Misericórdia de São Paulo, São Paulo, SP, Brazil
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Masuda H, Nemoto M, Harada N, Fuchinoue Y, Okonogi S, Node Y, Ando S, Kondo K, Sugo N. Comparison of quantitative measurements of central nervous system tumour consistency and the associated preoperative imaging findings. Br J Neurosurg 2019; 33:522-527. [DOI: 10.1080/02688697.2019.1617405] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
- Hiroyuki Masuda
- Department of Neurosurgery (Omori), School of Medicine, Faculty of Medicine, Toho University, Tokyo, Japan
| | - Masaaki Nemoto
- Department of Neurosurgery (Omori), School of Medicine, Faculty of Medicine, Toho University, Tokyo, Japan
| | - Naoyuki Harada
- Department of Neurosurgery (Omori), School of Medicine, Faculty of Medicine, Toho University, Tokyo, Japan
| | - Yutaka Fuchinoue
- Department of Neurosurgery (Omori), School of Medicine, Faculty of Medicine, Toho University, Tokyo, Japan
| | - Shinichi Okonogi
- Department of Neurosurgery (Omori), School of Medicine, Faculty of Medicine, Toho University, Tokyo, Japan
| | - Yasuhiro Node
- Department of Neurosurgery (Omori), School of Medicine, Faculty of Medicine, Toho University, Tokyo, Japan
| | - Shunpei Ando
- Department of Neurosurgery (Omori), School of Medicine, Faculty of Medicine, Toho University, Tokyo, Japan
| | - Kosuke Kondo
- Department of Neurosurgery (Omori), School of Medicine, Faculty of Medicine, Toho University, Tokyo, Japan
| | - Nobuo Sugo
- Department of Neurosurgery (Omori), School of Medicine, Faculty of Medicine, Toho University, Tokyo, Japan
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Sengul D, Sengul I, Van Slycke S. Risk stratification of the thyroid nodule with Bethesda indeterminate cytology, category III, IV, V on the one surgeon-performed US-guided fine-needle aspiration with 27-gauge needle, verified by histopathology of thyroidectomy: the additional value of one surgeon-performed elastography. Acta Chir Belg 2019; 119:38-46. [PMID: 30606092 DOI: 10.1080/00015458.2018.1551769] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
BACKGROUND The aim is to assess the value of strain elastography (SE) in differentiating likelihood of malignancy for the thyroid nodules, possessing the Bethesda Category III, IV, and V indeterminate cytology. METHODS The data was obtained by ultrasonography (US)-guided fine-needle aspiration (US-g-FNA) via 27-gauge needle, with the verification of indicated thyroidectomies in a retrospective analysis, from April 2010 to April 2014, by enrolling the documents of 262 consecutive patients, with 327 thyroid nodules, subjected to one-surgeon performed neck US, SE, and US-g-FNA with 27-G needle to rule out the malignancy. RESULTS 122 of 327 cases were Bethesda Category III, IV, and V with histopathologically benign, 110 (90.2%); PTC, 7 (5.7%); FTC, 4 (3.3%); HCC, 1 (0.8%). Tsukuba Elasticity Score (TES) 1, 2, 3, 4, and 5 were detected as 38 (31.1%), 8 (6.6%), 59 (48.4%), 4 (3.3%), and 13 (10.7%), respectively for the cases with the indeterminate cytology. No significant difference was detected between TES 4 and 5 and malign histopathology by McNemar test (p = .727) with a good level of concordance, the kappa coefficient, 0.737. CONCLUSION SE may be a useful tool in differentiating malign from benign thyroid nodules by selecting surgery adaptation even for Bethesda indeterminate cytology on FNAC.
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Affiliation(s)
- Demet Sengul
- Department of Pathology, Giresun University Faculty of Medicine, Giresun, Turkey
| | - Ilker Sengul
- Division of Endocrine Surgery, Giresun University Faculty of Medicine, Giresun, Turkey
- Department of General Surgery, Giresun University Faculty of Medicine, Giresun, Turkey
| | - Sam Van Slycke
- Department of General and Endocrine Surgery, OLV Ziekenhuis Aalst, Aalst, Belgium
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He Y, Wang XY, Hu Q, Chen XX, Ling B, Wei HM. Value of Contrast-Enhanced Ultrasound and Acoustic Radiation Force Impulse Imaging for the Differential Diagnosis of Benign and Malignant Thyroid Nodules. Front Pharmacol 2018; 9:1363. [PMID: 30542283 PMCID: PMC6277905 DOI: 10.3389/fphar.2018.01363] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2018] [Accepted: 11/05/2018] [Indexed: 11/13/2022] Open
Abstract
Objectives: To assess the value of contrast-enhanced ultrasound (CEUS) and acoustic radiation force impulse (ARFI) imaging for the differential diagnosis of benign and malignant thyroid nodules. Methods: CEUS was performed in eighty-eight thyroid nodules. The patterns of CEUS were analyzed, and ARFI was then performed. The shear wave velocities (SWVs) of the nodules and the surrounding normal thyroid tissue were obtained. The areas under the curve (AUCs) and cut-off value were obtained by a receiver operating characteristic (ROC) curve analysis. The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and diagnostic rate of each modality were assessed and compared using pathological diagnosis. Results: Among 88 nodules, 29 nodules were malignant and 59 were benign. The sensitivity, specificity, PPV, NPV, and diagnostic rate of CEUS were 79.3, 91.5, 82.1, 90, and 87.5%, respectively. Using a cut-off value of 2.565 m/s for SWV, the sensitivity, specificity, PPV, NPV and diagnostic rate for malignancy were 75.9, 94.9, 88.0, 88.9, and 88.6%, respectively. The AUC was 0.878. The sensitivity, specificity, PPV, NPV and diagnostic rate of CEUS in combination with ARFI were 93.1, 89.8, 81.8, 96.3, and 90.9%, respectively. Conclusion: Both CEUS and ARFI are valuable for the differential diagnosis of benign and malignant thyroid nodules. Combining these two methods can improve the diagnostic rate.
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Affiliation(s)
- Yan He
- Department of Ultrasound, The People's Hospital of Guangxi Zhuang Autonomous Region, Nanning, China
| | - Xiao Yan Wang
- Department of Ultrasound, The People's Hospital of Guangxi Zhuang Autonomous Region, Nanning, China
| | - Qiao Hu
- Department of Ultrasound, The People's Hospital of Guangxi Zhuang Autonomous Region, Nanning, China
| | - Xue Xue Chen
- Department of Ultrasound, The People's Hospital of Guangxi Zhuang Autonomous Region, Nanning, China
| | - Bing Ling
- Department of Ultrasound, The People's Hospital of Guangxi Zhuang Autonomous Region, Nanning, China
| | - Hai Ming Wei
- Department of Pathology, The People's Hospital of Guangxi Zhuang Autonomous Region, Nanning, China
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Fukuhara T, Matsuda E, Donishi R, Koyama S, Miyake N, Fujiwara K, Takeuchi H. Clinical efficacy of novel elastography using acoustic radiation force impulse (ARFI) for diagnosis of malignant thyroid nodules. Laryngoscope Investig Otolaryngol 2018; 3:319-325. [PMID: 30186965 PMCID: PMC6119802 DOI: 10.1002/lio2.165] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2017] [Revised: 03/14/2018] [Accepted: 04/02/2018] [Indexed: 12/21/2022] Open
Abstract
Objective Acoustic radiation force impulse (ARFI) imaging is a recent ultrasound elastography technique; consequently, its efficacy is not fully known. In this study, we compared ARFI imaging with conventional strain elastography (SE) and shear wave velocities (SWVs) to evaluate the utility of ARFI imaging for diagnosing thyroid nodules. Subjects and Methods In this study we examined 233 thyroid nodules (183 benign nodules and 50 malignant nodules) isolated from human patients. The nodules were evaluated with SE and ARFI imaging, and SWVs of the nodules were simultaneously measured. ARFI images were classified using a four‐point score based on grayscale intensity of the images. The sensitivity, specificity, and diagnostic accuracy were compared between SE and ARFI imaging. Finally, SWVs for each score of SE and ARFI imaging were compared. Results The new scoring system for ARFI imaging can be divided into four virtual touch imaging (VTI) scores. Nodules with a VTI score of 3 or 4 as determined by ARFI imaging were determined to be malignant. The sensitivity, specificity, and diagnostic accuracy, respectively, were 63.2%, 66.3%, and 65.6% for SE, compared with 80.0%, 86.3%, and 85.0% for ARFI imaging. The median SWVs of the nodules were 1.57 m/s, 1.73 m/s, 1.88 m/s, and 2.09 m/s for VTI scores of 1, 2, 3, and 4, respectively. The SWVs of VTI scores 3 and 4 were significantly higher than those of VTI scores 1 and 2. Conclusions The diagnostic accuracy of ARFI imaging for differentiating malignant thyroid nodules was higher than that of SE. The VTI scores of the nodules accurately reflected their SWVs. Level of Evidence 4
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Affiliation(s)
- Takahiro Fukuhara
- Department of Otolaryngology, Head and Neck Surgery Tottori University Faculty of Medicine Yonago Japan
| | - Eriko Matsuda
- Department of Otolaryngology, Head and Neck Surgery Tottori University Faculty of Medicine Yonago Japan
| | - Ryohei Donishi
- Department of Otolaryngology, Head and Neck Surgery Tottori University Faculty of Medicine Yonago Japan
| | - Satoshi Koyama
- Department of Otolaryngology, Head and Neck Surgery Tottori University Faculty of Medicine Yonago Japan
| | - Naritomo Miyake
- Department of Otolaryngology, Head and Neck Surgery Tottori University Faculty of Medicine Yonago Japan
| | - Kazunori Fujiwara
- Department of Otolaryngology, Head and Neck Surgery Tottori University Faculty of Medicine Yonago Japan
| | - Hiromi Takeuchi
- Department of Otolaryngology, Head and Neck Surgery Tottori University Faculty of Medicine Yonago Japan
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Hu X, Liu Y, Qian L. Diagnostic potential of real-time elastography (RTE) and shear wave elastography (SWE) to differentiate benign and malignant thyroid nodules: A systematic review and meta-analysis. Medicine (Baltimore) 2017; 96:e8282. [PMID: 29068996 PMCID: PMC5671829 DOI: 10.1097/md.0000000000008282] [Citation(s) in RCA: 44] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Real-time elastography (RTE) and shear wave elastography (SWE) are noninvasive and easily available imaging techniques that measure the tissue strain, and it has been reported that the sensitivity and the specificity of elastography were better in differentiating between benign and malignant thyroid nodules than conventional technologies. METHODS Relevant articles were searched in multiple databases; the comparison of elasticity index (EI) was conducted with the Review Manager 5.0. Forest plots of the sensitivity and specificity and SROC curve of RTE and SWE were performed with STATA 10.0 software. In addition, sensitivity analysis and bias analysis of the studies were conducted to examine the quality of articles; and to estimate possible publication bias, funnel plot was used and the Egger test was conducted. RESULTS Finally 22 articles which eventually satisfied the inclusion criteria were included in this study. After eliminating the inefficient, benign and malignant nodules were 2106 and 613, respectively. The meta-analysis suggested that the difference of EI between benign and malignant nodules was statistically significant (SMD = 2.11, 95% CI [1.67, 2.55], P < .00001). The overall sensitivities of RTE and SWE were roughly comparable, whereas the difference of specificities between these 2 methods was statistically significant. In addition, statistically significant difference of AUC between RTE and SWE was observed between RTE and SWE (P < .01). CONCLUSION The specificity of RTE was statistically higher than that of SWE; which suggests that compared with SWE, RTE may be more accurate on differentiating benign and malignant thyroid nodules.
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Affiliation(s)
- Xiangdong Hu
- Department of Ultrasound, Beijing Friendship Hospital, Capital Medical University, Beijing, China
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Franchi-Abella S, Elie C, Correas JM. Performances and Limitations of Several Ultrasound-Based Elastography Techniques: A Phantom Study. ULTRASOUND IN MEDICINE & BIOLOGY 2017; 43:2402-2415. [PMID: 28760576 DOI: 10.1016/j.ultrasmedbio.2017.06.008] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/25/2016] [Revised: 06/03/2017] [Accepted: 06/05/2017] [Indexed: 06/07/2023]
Abstract
The objective of this study is to assess strain and shear wave (SW) elastography performance in terms of accuracy by performing in vitro measurements on a calibrated elastography phantom. Acquisitions were done on a phantom containing 4 inclusions (12-74 kPa) embedded in a homogeneous background material (30 kPa). We performed qualitative assessment on elastograms, semiquantitative assessment with strain or elasticity ratios between each inclusion and the background and quantitative evaluation with SW acquisitions. Ratio and elasticity estimations were compared with expected values. Biases, relative errors and 95% confidence intervals (95% CI) were calculated. All techniques adequately classified inclusions as harder or softer than the background. For stiffness ratio estimation, SW methods were more precise than strain methods and had significantly higher percentages of correctly classified measurements (p = 0.008). Quantitative stiffness measurements were reproducible despite constant biases. SW elastography methods provide more reproducible estimations of tissue stiffness ratio than strain methods, as well as reproducible quantitative tissue stiffness despite constant biases.
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Affiliation(s)
- Stéphanie Franchi-Abella
- Pediatric Radiology Department-Bicêtre Hospital, Hôpitaux Universitaires Paris-Sud- Assistance Publique Hôpitaux de Paris-Université Paris Sud, Le Kremlin-Bicêtre, France.
| | - Caroline Elie
- Clinical Research Unit-Clinical Investigation Centre-Necker Enfants-Malades Hospital-Université, Paris Descartes, Sorbonne Paris Cite, France
| | - Jean-Michel Correas
- Adult Radiology Department- Necker Enfants-Malades Hospital-Université, Paris Descartes, Sorbonne Paris Cite, Paris, France
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Zhan J, Diao XH, Chen L, Jin JM, Chen Y. Role of Contrast-Enhanced Ultrasound in Diagnosis of Thyroid Nodules in Acoustic Radiation Force Impulse "Gray Zone". ULTRASOUND IN MEDICINE & BIOLOGY 2017; 43:1179-1186. [PMID: 28433441 DOI: 10.1016/j.ultrasmedbio.2017.02.006] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/29/2016] [Revised: 02/02/2017] [Accepted: 02/07/2017] [Indexed: 06/07/2023]
Abstract
The aim of this study was to evaluate the clinical value of contrast-enhanced ultrasound (CEUS) in the diagnosis of thyroid nodules in the acoustic radiation force impulse (ARFI) "gray zone" (the shear wave velocity is in the range 2.5-3 m/s). ARFI was performed before thyroidectomy in 70 patients with 200 thyroid nodules, and then CEUS was performed in 40 thyroid nodules in the "gray zone." The accuracy of ARFI for the 200 thyroid nodules was 82% (164/200). The accuracy of ARFI for the 40 "gray zone" thyroid nodules was 70% (28/40), whereas the accuracy of CEUS for the "gray zone" thyroid nodules was 90% (36/40). There was a significant difference in accuracy (p < 0.05). CEUS has better accuracy for thyroid nodules in the ARFI "gray zone." CEUS supplemented ARFI in differential diagnosis of benign and malignant thyroid nodules.
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Affiliation(s)
- Jia Zhan
- Department of Ultrasound, Huadong Hospital, Fudan University, Shanghai, China
| | - Xue-Hong Diao
- Department of Ultrasound, Huadong Hospital, Fudan University, Shanghai, China
| | - Lin Chen
- Department of Ultrasound, Huadong Hospital, Fudan University, Shanghai, China
| | - Jia-Mei Jin
- Department of Ultrasound, Huadong Hospital, Fudan University, Shanghai, China
| | - Yue Chen
- Department of Ultrasound, Huadong Hospital, Fudan University, Shanghai, China.
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Lou Z, Yang J, Tang L, Jin Y, Zhang J, Liu C, Li Q. Shear Wave Elastography Imaging for the Features of Symptomatic Carotid Plaques: A Feasibility Study. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2017; 36:1213-1223. [PMID: 28218798 DOI: 10.7863/ultra.16.04073] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/26/2016] [Accepted: 08/10/2016] [Indexed: 06/06/2023]
Abstract
OBJECTIVES Shear wave elastography (SWE) was performed to evaluate the Young's modulus of carotid plaques in patients presenting with cerebrovascular incidents, to estimate the clinical value and feasibility of this approach. METHODS Sixty-one patients (mean age, 65 years; 45 men) underwent common duplex ultrasonic examination and SWE evaluation. The patients were divided into the symptomatic and asymptomatic groups based on the presence of unilateral focal neurological symptoms. Elasticity and echogenicity of the carotid plaque was assessed by Young's modulus and Gray-Weale classification, respectively. RESULTS A total of 271 carotid plaques were assessed through duplex ultrasonic examination and SWE imaging. The Bland-Altman test revealed a perfect reproducibility of Young's modulus measurement using SWE. The interframe coefficient of variation was 16% within the 271 plaques. In the 61 representative plaques, significant correlations were found between Gray-Weale classification and mean Young's modulus (r = 0.728, P < .01) when the confounding factors were controlled. The mean Young's modulus of representative plaques in symptomatic group was lower than those in asymptomatic groups (mean Young's modulus: 81 kPa versus 115 kPa; P < .01). Logistic regression combined with receiver operating characteristic analysis suggested increased sensitivity and specificity for the identification of symptomatic carotid plaques when the mean Young's modulus was combined with stenosis rate. CONCLUSIONS Shear wave elastography can evaluate the Young's modulus of carotid plaque stably, and could serve as an additional method for the detection of symptomatic carotid plaques, which, in combination with common ultrasound, can promote the efficiency of differentiating symptomatic carotid plaques.
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Affiliation(s)
- Zhe Lou
- Department of Cardiovascular Ultrasound, the First Affiliated Hospital of China Medical University, Shenyang, China
| | - Jun Yang
- Department of Cardiovascular Ultrasound, the First Affiliated Hospital of China Medical University, Shenyang, China
| | - Li Tang
- Department of Cardiovascular Ultrasound, the First Affiliated Hospital of China Medical University, Shenyang, China
| | - Youhe Jin
- Department of Cardiovascular Ultrasound, the First Affiliated Hospital of China Medical University, Shenyang, China
| | - Jinsong Zhang
- Department of Cardiovascular Ultrasound, the First Affiliated Hospital of China Medical University, Shenyang, China
| | - Chao Liu
- Department of Cardiovascular Ultrasound, the First Affiliated Hospital of China Medical University, Shenyang, China
| | - Qiaobei Li
- Department of Abdominal Ultrasonic Diagnosis, the First Affiliated Hospital of China Medical University, Shenyang, China
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Sun CY, Lei KR, Liu BJ, Bo XW, Li XL, He YP, Wang D, Ren WW, Zhao CK, Xu HX. Virtual touch tissue imaging and quantification (VTIQ) in the evaluation of thyroid nodules: the associated factors leading to misdiagnosis. Sci Rep 2017; 7:41958. [PMID: 28157195 PMCID: PMC5291218 DOI: 10.1038/srep41958] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2016] [Accepted: 01/03/2017] [Indexed: 12/05/2022] Open
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.
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Affiliation(s)
- Cheng-Yu Sun
- Department of Medical Ultrasound, Shanghai Tenth People's Hospital, Ultrasound Research and Education Institute, Tongji University School of Medicine, Shanghai 200072, China.,Department of Medical Ultrasound, Yangpu Hospital, Tongji University School of Medicine, Shanghai 200090, China.,Thyroid Institute, Tongji University School of Medicine, Shanghai 200072, China.,Shanghai Center for Thyroid Diseases, Shanghai, 200072, China
| | - Kai-Rong Lei
- Department of Medical Ultrasound, Yangpu Hospital, Tongji University School of Medicine, Shanghai 200090, China
| | - Bo-Ji Liu
- Department of Medical Ultrasound, Shanghai Tenth People's Hospital, Ultrasound Research and Education Institute, Tongji University School of Medicine, Shanghai 200072, China.,Thyroid Institute, Tongji University School of Medicine, Shanghai 200072, China.,Shanghai Center for Thyroid Diseases, Shanghai, 200072, China
| | - Xiao-Wan Bo
- Department of Medical Ultrasound, Shanghai Tenth People's Hospital, Ultrasound Research and Education Institute, Tongji University School of Medicine, Shanghai 200072, China.,Thyroid Institute, Tongji University School of Medicine, Shanghai 200072, China.,Shanghai Center for Thyroid Diseases, Shanghai, 200072, China
| | - Xiao-Long Li
- Department of Medical Ultrasound, Shanghai Tenth People's Hospital, Ultrasound Research and Education Institute, Tongji University School of Medicine, Shanghai 200072, China.,Thyroid Institute, Tongji University School of Medicine, Shanghai 200072, China.,Shanghai Center for Thyroid Diseases, Shanghai, 200072, China
| | - Ya-Ping He
- Department of Medical Ultrasound, Shanghai Tenth People's Hospital, Ultrasound Research and Education Institute, Tongji University School of Medicine, Shanghai 200072, China.,Shanghai Center for Thyroid Diseases, Shanghai, 200072, China
| | - Dan Wang
- Department of Medical Ultrasound, Shanghai Tenth People's Hospital, Ultrasound Research and Education Institute, Tongji University School of Medicine, Shanghai 200072, China.,Thyroid Institute, Tongji University School of Medicine, Shanghai 200072, China.,Shanghai Center for Thyroid Diseases, Shanghai, 200072, China
| | - Wei-Wei Ren
- Department of Medical Ultrasound, Shanghai Tenth People's Hospital, Ultrasound Research and Education Institute, Tongji University School of Medicine, Shanghai 200072, China.,Thyroid Institute, Tongji University School of Medicine, Shanghai 200072, China.,Shanghai Center for Thyroid Diseases, Shanghai, 200072, China
| | - Chong-Ke Zhao
- Department of Medical Ultrasound, Shanghai Tenth People's Hospital, Ultrasound Research and Education Institute, Tongji University School of Medicine, Shanghai 200072, China.,Thyroid Institute, Tongji University School of Medicine, Shanghai 200072, China.,Shanghai Center for Thyroid Diseases, Shanghai, 200072, China
| | - Hui-Xiong Xu
- Department of Medical Ultrasound, Shanghai Tenth People's Hospital, Ultrasound Research and Education Institute, Tongji University School of Medicine, Shanghai 200072, China.,Thyroid Institute, Tongji University School of Medicine, Shanghai 200072, China.,Shanghai Center for Thyroid Diseases, Shanghai, 200072, China
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Cosgrove D, Barr R, Bojunga J, Cantisani V, Chammas MC, Dighe M, Vinayak S, Xu JM, Dietrich CF. WFUMB Guidelines and Recommendations on the Clinical Use of Ultrasound Elastography: Part 4. Thyroid. ULTRASOUND IN MEDICINE & BIOLOGY 2017; 43:4-26. [PMID: 27570210 DOI: 10.1016/j.ultrasmedbio.2016.06.022] [Citation(s) in RCA: 170] [Impact Index Per Article: 24.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/20/2023]
Abstract
The World Federation for Ultrasound in Medicine and Biology (WFUMB) has produced guidelines for the use of elastography techniques including basic science, breast and liver. Here we present elastography in thyroid diseases. For each available technique, procedure, reproducibility, results and limitations are analyzed and recommendations are given. Finally, recommendations are given based on the level of evidence of the published literature and on the WFUMB expert group's consensus. The document has a clinical perspective and is aimed at assessing the usefulness of elastography in the management of thyroid diseases.
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Affiliation(s)
- David Cosgrove
- Division of Radiology, Imperial and Kings Colleges, London, UK
| | - Richard Barr
- Department of Radiology, Northeastern Ohio Medical University, Rootstown, Ohio, USA; Southwoods Imaging, Youngstown, Ohio, USA
| | - Joerg Bojunga
- Department of Internal Medicine 1, Endocrinology and Diabetology, Goethe University Hospital, Frankfurt am Main, Germany
| | - Vito Cantisani
- Department of Radiological Sciences, Oncology and Pathology, Policlinico Umberto I, University Sapienza, Rome, Italy
| | - Maria Cristina Chammas
- Ultrasound Division, Department of Radiology, Hospital das Clínicas, School of Medicine, University of São Paulo, São Paulo, Brazil
| | - Manjiri Dighe
- Department of Radiology, University of Washington, Seattle, Washington, USA
| | - Sudhir Vinayak
- Department of Imaging and Diagnostic Radiology, Aga Khan University Hospital, Nairobi, Kenya
| | - Jun-Mei Xu
- Department of Medical Ultrasound, Shanghai Tenth People's Hospital, Ultrasound Research and Education Institute, Tongji University School of Medicine, China
| | - Christoph F Dietrich
- Department of Internal Medicine 2, Caritas Krankenhaus, Bad Mergentheim, Germany; Sino-German Research Center of Ultrasound in Medicine, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.
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15
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Hofauer B, Mansour N, Heiser C, Wirth M, Straßen U, Loeffelbein D, Bas M, Knopf A. Reproducibility of Acoustic Radiation Force Impulse Imaging in Thyroid and Salivary Glands with Experienced and Inexperienced Examiners. ULTRASOUND IN MEDICINE & BIOLOGY 2016; 42:2545-2552. [PMID: 27475926 DOI: 10.1016/j.ultrasmedbio.2016.06.019] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/09/2016] [Revised: 06/07/2016] [Accepted: 06/10/2016] [Indexed: 06/06/2023]
Abstract
Acoustic radiation force impulse (ARFI) imaging enables the sonographic measurement of tissue stiffness. The aim of this study was to evaluate if experience in ARFI imaging influences the reproducibility of ARFI imaging of the head and neck. Three experienced sonographers and three inexperienced sonographers performed ARFI imaging of thyroid, submandibular and parotid glands in 10 healthy volunteers. The examination was repeated after 2 wk. Ten single ARFI measurements were done in every gland. Inter-rater and intra-rater reliability was analyzed using the intra-class correlation coefficient (ICC). Moderate agreement was observed between experienced and inexperienced examiners (ICC = 0.46). In salivary glands, agreement was fair between the groups (ICC = 0.33), whereas in separate evaluations, inter-rater reliability in the submandibular glands was moderate (ICC = 0.52), and that in the parotid glands, only poor (ICC = 0.09). For ARFI imaging of the thyroid gland, there was moderate agreement between the groups (ICC = 0.50). The intra-rater reliability for the salivary and thyroid glands together and separately was strong in both groups. ARFI imaging of the thyroid and salivary glands did exhibit good reproducibility. ARFI imaging of the thyroid gland reached the highest levels of inter- and intra-observer agreement in both groups. ARFI imaging in salivary glands is only reproducible with experienced examiners.
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Affiliation(s)
- Benedikt Hofauer
- Otorhinolaryngology/Head and Neck Surgery, Klinikum rechts der Isar, Technical University Munich, Munich, Germany.
| | - Naglaa Mansour
- Otorhinolaryngology/Head and Neck Surgery, Klinikum rechts der Isar, Technical University Munich, Munich, Germany
| | - Clemens Heiser
- Otorhinolaryngology/Head and Neck Surgery, Klinikum rechts der Isar, Technical University Munich, Munich, Germany
| | - Markus Wirth
- Otorhinolaryngology/Head and Neck Surgery, Klinikum rechts der Isar, Technical University Munich, Munich, Germany
| | - Ulrich Straßen
- Otorhinolaryngology/Head and Neck Surgery, Klinikum rechts der Isar, Technical University Munich, Munich, Germany
| | - Denys Loeffelbein
- Cranio-Maxillo-Facial Surgery, Klinikum rechts der Isar, Technical University Munich, Munich, Germany
| | - Murat Bas
- Otorhinolaryngology/Head and Neck Surgery, Klinikum rechts der Isar, Technical University Munich, Munich, Germany
| | - Andreas Knopf
- Otorhinolaryngology/Head and Neck Surgery, Klinikum rechts der Isar, Technical University Munich, Munich, Germany
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16
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Neuwirt C, Jaeger H, Kratzer W, Tasdemir S, Haenle MM, Graeter T. Acoustic radiation force imaging of the thyroid—generation of reference values by Virtual Touch Imaging and Quantification. Clin Imaging 2016; 40:1061-4. [DOI: 10.1016/j.clinimag.2016.05.010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2016] [Revised: 05/11/2016] [Accepted: 05/31/2016] [Indexed: 11/28/2022]
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17
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Impact of Fibrotic Tissue on Shear Wave Velocity in Thyroid: An Ex Vivo Study with Fresh Thyroid Specimens. BIOMED RESEARCH INTERNATIONAL 2015; 2015:569367. [PMID: 26881199 PMCID: PMC4735986 DOI: 10.1155/2015/569367] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/10/2015] [Accepted: 12/20/2015] [Indexed: 12/30/2022]
Abstract
We sought to elucidate the correlation between shear wave velocity (SWV) and fibrosis in thyroid by precisely assessing pathological structures inside 5 × 5 mm(2) regions of interest (ROIs) of resected specimens, under conditions that excluded physical artifacts. The materials were unselected thyroid and lymph node specimens resected during thyroid surgery. Immediately after surgery, fresh unfixed thyroid and metastatic lymph node specimens were suspended in gel phantoms, and SWV was measured. Upon pathological examination of each specimen, the extent of fibrosis was graded as none, moderate, or severe. A total of 109 specimens were evaluated: 15 normal thyroid, 16 autoimmune thyroiditis, 40 malignant nodules, 19 benign thyroid nodules, and 19 metastatic lymph nodes. When all specimens were classified according to the degree of fibrosis determined by pathological imaging, the mean SWV was 1.49 ± 0.39 m/s for no fibrosis, 2.13 ± 0.66 m/s for moderate fibrosis, and 2.68 ± 0.82 m/s for severe fibrosis. The SWVs of samples with moderate and severe fibrosis were significantly higher than those of samples without fibrosis. The results of this study demonstrate that fibrosis plays an important role in determining stiffness, as measured by SWV in thyroid.
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Tian W, Hao S, Gao B, Jiang Y, Zhang S, Guo L, Luo D. Comparison of Diagnostic Accuracy of Real-Time Elastography and Shear Wave Elastography in Differentiation Malignant From Benign Thyroid Nodules. Medicine (Baltimore) 2015; 94:e2312. [PMID: 26717367 PMCID: PMC5291608 DOI: 10.1097/md.0000000000002312] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Thyroid nodules are relatively more prevalent in iodine-deficiency area, and the incidence increased sharply in the past decade in these areas. Workup of malignant from benign nodules in clinic was the main problem for managing thyroid nodules.An overall search for the articles about the diagnostic performance of real-time elastography (RTE) and shear wave elastography (SWE) before April 2015 in the databases of PubMed, Embase, and Google scholar. The pooled sensitivity, specificity, and summary receiver operating characteristic (SROC) curve were obtained from individual studies with a random-effects model. Subgroup and meta-regression analysis were also performed.Fifty-six studies involved in 2621 malignant nodules and 7380 benign nodules were contained in our meta-analysis. The pooled sensitivity and specificity of RTE was 83.0% and 81.2%, which is higher than SWE (sensitivity: 78.7%, specificity: 80.5%). The areas under the SROC curve of RTE and SWE were 0.885 and 0.842 respectively. RTE had higher diagnostic value for Caucasians than Asians. Stran ratio (SR) assessment had higher diagnostic performance than elasticity score (ES) system. Similarly, it had higher diagnostic value when malignant nodules were more than 50.In summary, the results revealed that RTE had higher diagnostic performance than SWE in differentiating malignant from benign nodules. However, future international multicenter studies in the region of thyroid risk need to further assess the diagnostic performance of RTE.
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Affiliation(s)
- Wuguo Tian
- From the Department of Breast, Thyroid, and Vascular Surgery, Research Institute of Surgery, Daping Hospital, Third Military Medical University, Chongqing, China
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19
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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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20
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Mantsopoulos K, Klintworth N, Iro H, Bozzato A. Applicability of shear wave elastography of the major salivary glands: values in healthy patients and effects of gender, smoking and pre-compression. ULTRASOUND IN MEDICINE & BIOLOGY 2015; 41:2310-2318. [PMID: 26022793 DOI: 10.1016/j.ultrasmedbio.2015.04.015] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/13/2014] [Revised: 04/21/2015] [Accepted: 04/23/2015] [Indexed: 06/04/2023]
Abstract
Our aim in this study was to determine normal shear wave elastography (SWE) values for the parenchyma of the major salivary glands and to evaluate the influences of gender, smoking, side and type of gland and varying amounts of ultrasound probe pressure on SWE values. Twenty-five consecutive healthy patients were examined with ultrasound. SWE velocities were measured with acoustic radiation force imaging in the hilum and central region of both glands with "normal" and very low pressure. Mean SWE velocities were 1.854 m/s for the parotid gland and 1.932 m/s for the submandibular gland. No statistically significant differences were detected between males and females, smokers and non-smokers, parotid and submandibular gland and left and right sides. Greater pre-compression with the ultrasound probe resulted in a statistically significant increase in the SWE values of both salivary glands (p < 0.000). The degree of pre-compression by the ultrasound transducer should be standardized, so that the reliability and reproducibility of this innovative method can be improved.
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Affiliation(s)
- Konstantinos Mantsopoulos
- Department of Otorhinolaryngology, Head and Neck Surgery, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany.
| | - Nils Klintworth
- Department of Otorhinolaryngology, Head and Neck Surgery, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Heinrich Iro
- Department of Otorhinolaryngology, Head and Neck Surgery, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Alessandro Bozzato
- Department of Otorhinolaryngology, Head and Neck Surgery, University of Homburg, Homburg, Germany
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Fukuhara T, Matsuda E, Endo Y, Takenobu M, Izawa S, Fujiwara K, Kitano H. Correlation between quantitative shear wave elastography and pathologic structures of thyroid lesions. ULTRASOUND IN MEDICINE & BIOLOGY 2015; 41:2326-2332. [PMID: 26055967 DOI: 10.1016/j.ultrasmedbio.2015.05.001] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/07/2015] [Revised: 04/16/2015] [Accepted: 05/04/2015] [Indexed: 06/04/2023]
Abstract
The aim of this study was to determine the correlation between shear wave velocity (SWV) generated by acoustic radiation force impulse and the pathologic structure of thyroid lesions. A total of 599 thyroid tissue samples were divided into four groups based on pathologic structure: 254 normal thyroid tissue samples as a control, 128 with chronic autoimmune thyroiditis (CAT) that demonstrated diffuse fibrosis, 165 with benign nodules that had high cell density and 52 with papillary thyroid carcinoma (PTC) that showed high cell density and fibrosis. The mean SWVs in each group were as follows: 1.60 ± 0.18 m/s in normal thyroid, 2.55 ± 0.28 m/s in CAT, 1.72 ± 0.31 m/s in benign nodules and 2.66 ± 0.95 m/s in PTC. The SWVs of CAT and PTC were significantly higher than those of normal thyroid, (p < 0.001). SWV was significantly affected by fibrosis.
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Affiliation(s)
- Takahiro Fukuhara
- Department of Otolaryngology-Head and Neck Surgery, Tottori University Faculty of Medicine, Yonago, Japan.
| | - Eriko Matsuda
- Department of Otolaryngology-Head and Neck Surgery, Tottori University Faculty of Medicine, Yonago, Japan
| | - Yukari Endo
- Department of Pathology, Tottori University Faculty of Medicine, Yonago, Japan
| | - Masao Takenobu
- Department of Otolaryngology-Head and Neck Surgery, Tottori University Faculty of Medicine, Yonago, Japan
| | - Shoichiro Izawa
- Endocrinology and Metabolism, Department of Molecular Medicine and Therapeutics, Tottori University Faculty of Medicine, Yonago, Japan
| | - Kazunori Fujiwara
- Department of Otolaryngology-Head and Neck Surgery, Tottori University Faculty of Medicine, Yonago, Japan
| | - Hiroya Kitano
- Department of Otolaryngology-Head and Neck Surgery, Tottori University Faculty of Medicine, Yonago, Japan
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Zhan J, Jin JM, Diao XH, Chen Y. Acoustic radiation force impulse imaging (ARFI) for differentiation of benign and malignant thyroid nodules--A meta-analysis. Eur J Radiol 2015; 84:2181-6. [PMID: 26259701 DOI: 10.1016/j.ejrad.2015.07.015] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2015] [Revised: 06/30/2015] [Accepted: 07/09/2015] [Indexed: 10/23/2022]
Abstract
OBJECTIVES Work-up of thyroid nodules remains challenging. Acoustic radiation force impulse imaging (ARFI)-generated shear wave elastography, which can measure quantitatively tissue stiffness (virtual touch tissue quantification) is used as a complement to conventional sonography for improving the diagnosis of thyroid nodules. This meta-analysis was performed to expand on a previous meta-analysis to assess the diagnostic power of ARFI in differentiating benign and malignant thyroid nodules. METHODS The MEDLINE, PubMed, SpringerLink databases up to December 31, 2014, were searched. The pooled sensitivity, specificity, and summary receiver operating characteristic curve were obtained from individual studies with a random effects model. RESULTS Sixteen studies that included a total of 2436 nodules in 2147 patients for ARFI studies were analyzed. The overall mean sensitivity and specificity of ARFI for differentiation of thyroid nodules were 0.80 (95% confidence interval [CI], 0.73-0.87) and 0.85 (95% CI, 0.80-0.90), respectively. A significant heterogeneity was found for both sensitivity and specificity of the different studies (P<0.001). The area under the curve for the ARFI was 0.91. CONCLUSIONS ARFI has high sensitivity and specificity for identification of thyroid. This technique might be useful to select patients with thyroid nodules for surgery.
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Affiliation(s)
- Jia Zhan
- Department of Ultrasound Huadong Hospital, Fudan University, Shanghai, PR China.
| | - Jia-Mei Jin
- Department of Ultrasound Huadong Hospital, Fudan University, Shanghai, PR China.
| | - Xue-Hong Diao
- Department of Ultrasound Huadong Hospital, Fudan University, Shanghai, PR China.
| | - Yue Chen
- Department of Ultrasound Huadong Hospital, Fudan University, Shanghai, PR China.
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Utility of Shear Wave Elastography for Diagnosing Chronic Autoimmune Thyroiditis. J Thyroid Res 2015; 2015:164548. [PMID: 26257979 PMCID: PMC4519543 DOI: 10.1155/2015/164548] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2015] [Revised: 06/02/2015] [Accepted: 06/29/2015] [Indexed: 12/03/2022] Open
Abstract
The aims of this study were to evaluate the utility of shear wave elastography (SWE) using acoustic radiation force impulse (ARFI) for diagnosing chronic autoimmune thyroiditis (CAT) and to verify the effect of fibrotic thyroid tissue on shear wave velocity (SWV). The subjects were 229 patients with 253 normal thyroid lobes (controls) and 150 CAT lobes. The SWV for CAT (2.47 ± 0.57 m/s) was significantly higher than that for controls (1.59 ± 0.41 m/s) (P < 0.001). The area under the receiver operating characteristics (ROC) curve for CAT was 0.899, and the SWV cut-off value was 1.96 m/s. The sensitivity, specificity, and diagnostic accuracy were 87.4%, 78.7%, and 85.1%, respectively. Levels of anti-thyroperoxidase antibodies and thyroid isthmus thickness were correlated with tissue stiffness in CAT. However, there was no correlation between levels of anti-thyroglobulin antibodies and tissue stiffness. Quantitative SWE is useful for diagnosing CAT, and it is possible that SWE can be used to evaluate the degree of fibrosis in patients with CAT.
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