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Zhang F, Mei F, Chen W, Zhang Y. Role of Ultrasound and Ultrasound-Based Prediction Model in Differentiating Follicular Thyroid Carcinoma From Follicular Thyroid Adenoma. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2024; 43:1389-1399. [PMID: 38577871 DOI: 10.1002/jum.16461] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/09/2024] [Revised: 03/08/2024] [Accepted: 03/24/2024] [Indexed: 04/06/2024]
Abstract
OBJECTIVES This study aims to identify distinct ultrasound (US) characteristics for distinguishing follicular thyroid carcinoma (FTC) from follicular thyroid adenoma (FTA), and construct a user-friendly preoperative risk stratification model for thyroid follicular neoplasms. METHODS In this retrospective study, patients diagnosed with pathologically confirmed FTA or FTC and undergoing US examinations between July 2017 and June 2021 were designated as the training cohort, and those from July 2021 to June 2023 were enrolled as the external validation set. We systematically assessed and compared the sonographic and clinical characteristics of FTC and FTA. Univariable and multivariable logistic regression analyses were used to assess the association of US features with FTC in the training set. A prediction nomogram model, incorporating US features independently associated with FTC, was developed and validated externally to assess its performance. RESULTS A total of 645 patients (FTA/FTC = 530/115) were included in the training set, while 197 patients (FTA/FTC = 165/32) constituted the validation set. In the training set, solid composition, hypo-echogenicity, irregular margin, calcification, protrusion sign, trabecular formation, absent or thick halo, and mainly central hypervascularity were identified as independent factors associated with FTC. The prediction nomogram model constructed using these variables showed good performance in differentiating FTC from FTA with an area under the curve of 0.948 in the training set and 0.915 in the validation set. CONCLUSIONS The preoperative nomogram model constructed based on US features serves as an effective tool for the risk stratification of thyroid follicular neoplasms.
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Affiliation(s)
- Fan Zhang
- Department of Ultrasound, Peking University Third Hospital, Beijing, China
| | - Fang Mei
- Department of Pathology, Peking University Third Hospital, Beijing, China
| | - Wen Chen
- Department of Ultrasound, Peking University Third Hospital, Beijing, China
| | - Yongyue Zhang
- Department of Ultrasound, Peking University Third Hospital, Beijing, China
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Wang J, Cheng H, Li X. Modified TI-RADS Coupled with BRAFV600E Enhances Diagnostic Efficiency in Papillary Thyroid Carcinoma: Prospective Study. Int J Gen Med 2024; 17:3015-3025. [PMID: 39006910 PMCID: PMC11246655 DOI: 10.2147/ijgm.s456820] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2023] [Accepted: 06/09/2024] [Indexed: 07/16/2024] Open
Abstract
Background Thyroid disorders, relatively common diseases of the endocrine system, have risen gradually in recent years. Early detection and accurate diagnosis of thyroid cancer hold exceptional importance. This study aimed to determine the efficacy of a modified TI-RADS and BRAFV600E mutation testing for thyroid cancer (PTC) diagnosis. Methods Ninety five thyroid nodules (48 benign and 47 malignant) from 81 patients were examined using Kwak Thyroid Imaging Reporting and Data System (TI-RADS) were subjected to shear wave elasticity (SWE), BRAFV600E genotyping and fine needle aspiration (FNA) cytology. Results The modified TI-RADS exhibited superior diagnostic accuracy compared to TI-RADS in differentiating benign nodules from malignant thyroid nodules. Moreover, the AUC of modified TI-RADS in conjunction with BRAFV600E was the highest at 95% CI (0.898-0.992, p=0.003), surpassing other diagnostic methods in enhanced sensitivity and maintaining high specificity. Conclusion The diagnostic efficiency of this combination surpassed that of individual diagnostic methods.
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Affiliation(s)
- Jing Wang
- Department of Ultrasound, Bishan Hospital of Chongqing, Bishan Hospital of Chongqing Medical University, Chongqing, 402760, People’s Republic of China
| | - Hong Cheng
- Department of Ultrasound, Bishan Hospital of Chongqing, Bishan Hospital of Chongqing Medical University, Chongqing, 402760, People’s Republic of China
| | - Xu Li
- Department of Ultrasound, Bishan Hospital of Chongqing, Bishan Hospital of Chongqing Medical University, Chongqing, 402760, People’s Republic of China
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Kim MK, Park H, Oh YL, Shin JH, Kim TH, Hahn SY. Association of Ultrasonography Features of Follicular Thyroid Carcinoma With Tumor Invasiveness and Prognosis Based on WHO Classification and TERT Promoter Mutation. Korean J Radiol 2024; 25:103-112. [PMID: 38184773 PMCID: PMC10788599 DOI: 10.3348/kjr.2023.0461] [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] [Received: 05/25/2023] [Revised: 10/20/2023] [Accepted: 11/02/2023] [Indexed: 01/08/2024] Open
Abstract
OBJECTIVE To investigate the association of ultrasound (US) features of follicular thyroid carcinoma (FTC) with tumor invasiveness and prognosis based on the World Health Organization (WHO) classification and telomerase reverse transcriptase (TERT) promoter mutations. MATERIALS AND METHODS This retrospective study included 54 surgically confirmed FTC patients with US images and TERT promoter mutations (41 females and 13 males; median age [interquartile range], 40 years [30-51 years]). The WHO classification consisted of minimally invasive (MI), encapsulated angioinvasive (EA), and widely invasive (WI) FTCs. Alternative classifications included Group 1 (MI-FTC and EA-FTC with wild type TERT), Group 2 (WI-FTC with wild type TERT), and Group 3 (EA-FTC and WI-FTC with mutant TERT). Each nodule was categorized according to the US patterns of the Korean Thyroid Imaging Reporting and Data System (K-TIRADS) and American College of Radiology-TIRADS (ACR-TIRADS). The Jonckheere-Terpstra and Cochran-Armitage tests were used for statistical analysis. RESULTS Among 54 patients, 29 (53.7%) had MI-FTC, 16 (29.6%) had EA-FTC, and nine (16.7%) had WI-FTC. In both the classifications, lobulation, irregular margins, and final assessment categories showed significant differences (all Ps ≤ 0.04). Furthermore, the incidences of lobulation, irregular margin, and high suspicion category tended to increase with increasing tumor invasiveness and worse prognosis (all Ps for trend ≤ 0.006). In the WHO groups, hypoechogenicity differed significantly among the groups (P = 0.01) and tended to increase in proportion as tumor invasiveness increased (P for trend = 0.02). In the alternative group, punctate echogenic foci were associated with prognosis (P = 0.03, P for trend = 0.03). CONCLUSION Increasing tumor invasiveness and worsening prognosis in FTC based on the WHO classification and TERT promoter mutation results were positively correlated with US features that indicate malignant probability according to both K-TIRADS and ACR-TIRADS.
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Affiliation(s)
- Myoung Kyoung Kim
- Department of Radiology and Center for Imaging Science, Thyroid Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Hyunju Park
- Department of Medicine, Thyroid Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Young Lyun Oh
- Department of Pathology, Thyroid Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Jung Hee Shin
- Department of Radiology and Center for Imaging Science, Thyroid Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Tae Hyuk Kim
- Department of Medicine, Thyroid Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
| | - Soo Yeon Hahn
- Department of Radiology and Center for Imaging Science, Thyroid Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
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Zhang X, Chen Y, Chen W, Zhang Z. Combining Clinicopathologic and Ultrasonic Features for Predicting Skip Metastasis of Lateral Lymph Nodes in Papillary Thyroid Carcinoma. Cancer Manag Res 2023; 15:1297-1306. [PMID: 38027237 PMCID: PMC10657546 DOI: 10.2147/cmar.s434807] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2023] [Accepted: 11/09/2023] [Indexed: 12/01/2023] Open
Abstract
Background Skip metastasis, regarded as lateral lymph node metastasis (LLNM) without involving the central lymph node metastasis (CLNM), in papillary thyroid carcinoma (PTC) patients is commonly unpredictable. The purpose of the present research was to investigate the independent risk factors of skip metastasis in patients with PTC. Methods and Materials In the present research, 228 consecutive PTC patients who experienced total thyroidectomy coupled with central and lateral lymph node dissection from May 2020 to September 2022 at the Affiliated hospital of Jiangsu University were included in our research. Univariate and multivariate analysis were then applied to investigate the risk factors of skip metastasis in patients with PTC. Furthermore, a predictive model of skip metastasis was then constructed based on risk factors. Results The skip metastasis rate was 11.8% (27/228) in the current research. After the univariate and multivariate analysis, tumor size ≤ 10 mm, unilaterality, microcalcification, and upper tumor location were determined to be predictive factors of skip metastasis. The risk score of skip metastasis was calculated: risk score = 1.229 × (if tumor nodule ≤ 10mm) + 1.518 × (if unilaterality nodule) + 1.074 × (if microcalcification in nodule) + 2.332 × (if nodule in upper location). Conclusion Tumor size ≤ 10 mm, unilaterality, microcalcification, and upper tumor location can increase the occurrence of skip metastasis in patients with PTC, which is expected to provide useful information to guide the suitable intraoperative window.
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Affiliation(s)
- Xin Zhang
- Department of Medical Ultrasound, Affiliated Hospital of Jiangsu University, Zhenjiang, 212000, People’s Republic of China
| | - Ying Chen
- Department of Medical Pharmacy, Affiliated Hospital of Jiangsu University, Zhenjiang, 212000, People’s Republic of China
| | - Wanyin Chen
- Department of Medical Gynecology, Affiliated Hospital of Jiangsu University, Zhenjiang, 212000, People’s Republic of China
| | - Zheng Zhang
- Department of Medical Ultrasound, Affiliated Hospital of Jiangsu University, Zhenjiang, 212000, People’s Republic of China
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Li J, Li C, Zhou X, Huang J, Yang P, Cang Y, Zhai H, Huang R, Mu Y, Gou X, Zhang Y, Yu J, Liang P. US Risk Stratification System for Follicular Thyroid Neoplasms. Radiology 2023; 309:e230949. [PMID: 37987664 DOI: 10.1148/radiol.230949] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2023]
Abstract
Background Preoperative assessment of follicular thyroid neoplasms is challenging using the current US risk stratification systems (RSSs) that are applicable to papillary thyroid neoplasms. Purpose To develop a US feature-based RSS for differentiating between follicular thyroid adenoma (FTA) and follicular thyroid carcinoma (FTC) in biopsy-proven follicular neoplasm and compare it with existing RSSs. Materials and Methods This retrospective multicenter study included consecutive adult patients who underwent conventional US and received a final diagnosis of follicular thyroid neoplasm from seven centers between January 2018 and December 2022. US images from a pretraining data set were used to improve readers' understanding of the US characteristics of the FTC and FTA. Univariable and multivariable logistic regression analyses were used to assess the association of qualitative US features with FTC in a training data set. Features with P < .05 were used to construct a prediction model (follicular tumor model, referred to as F model) and RSS for follicular neoplasms using the Thyroid Imaging Reporting and Data System (TI-RADS). Area under the receiver operating characteristic curve (AUC) was compared between follicular TI-RADS (hereafter, F-TI-RADS) and existing RSS (American College of Radiology [ACR] TI-RADS, Korean Society of Thyroid Radiology and Korean Society of Radiology TI-RADS [hereafter, referred to as K-TI-RADS], and Chinese TI-RADS [hereafter, referred to as C-TI-RADS]) in a validation data set. Results The pretraining, training, and validation data sets included 30 (mean age, 47.6 years ± 16.0 [SD]; 16 male patients; FTCs, 30 of 60 [50.0%]), 703 (mean age, 47.9 years ± 14.5; 530 female patients; FTCs, 188 of 703 [26.7%]), and 155 (mean age, 49.9 years ± 13.3 [SD]; 155 female patients; FTCs, 43 of 155 [27.7%]) patients. In the validation data set, the F-TI-RADS showed improved performance for differentiating between FTA and FTC (AUC, 0.81; 95% CI: 0.71, 0.86) compared with ACR TI-RADS (AUC, 0.74; 95% CI: 0.66, 0.80; P = .02), K-TI-RADS (AUC, 0.69; 95% CI: 0.61, 0.76; P = .002), and C-TI-RADS (AUC, 0.68; 95% CI: 0.60, 0.75; P = .002). Conclusion F-TI-RADS outperformed existing RSSs for differentiating between FTC and FTA. © RSNA, 2023 Supplemental material is available for this article. See also the editorial by Baumgarten in this issue.
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Affiliation(s)
- Jianming Li
- From the Department of Interventional Ultrasound, Fifth Medical Center of Chinese PLA General Hospital, 28 Fuxing Road, Beijing 100853, China (J.L., J.Y., P.L.); Department of Ultrasound, The First Affiliated Hospital of Henan University of CM, Henan, China (C.L.); Department of Ultrasound Diagnostics, The Affiliated Changsha Central Hospital, Hengyang Medical School, University of South China, Hunan, China (X.Z.); Department of Ultrasound, Peking University Third Hospital, Beijing, China (J.H.); Department of Ultrasound, Beijing Friendship Hospital, Capital Medical University, Beijing, China (P.Y.); Department of Otolaryngology Head and Neck Surgery, Chinese PLA General Hospital, Beijing, China (Y.C.); Department of Ultrasound, Tianjin Medical University General Hospital, Tianjin, China (H.Z.); Department of Otolaryngology-Head & Neck Surgery, The Second Affiliated Hospital of Guilin Medical University, Guangxi, China (R.H.); Department of Ultrasound, Traditional Chinese Medical Hospital of Xinjiang, Xinjiang, China (Y.M.); Department of Pathology, First Medical Center of Chinese PLA General Hospital, Beijing, China (X.G.); and Department of Pathology, Affiliated Hospital of Hebei Engineering University, Hebei, China (Y.Z.)
| | - Chao Li
- From the Department of Interventional Ultrasound, Fifth Medical Center of Chinese PLA General Hospital, 28 Fuxing Road, Beijing 100853, China (J.L., J.Y., P.L.); Department of Ultrasound, The First Affiliated Hospital of Henan University of CM, Henan, China (C.L.); Department of Ultrasound Diagnostics, The Affiliated Changsha Central Hospital, Hengyang Medical School, University of South China, Hunan, China (X.Z.); Department of Ultrasound, Peking University Third Hospital, Beijing, China (J.H.); Department of Ultrasound, Beijing Friendship Hospital, Capital Medical University, Beijing, China (P.Y.); Department of Otolaryngology Head and Neck Surgery, Chinese PLA General Hospital, Beijing, China (Y.C.); Department of Ultrasound, Tianjin Medical University General Hospital, Tianjin, China (H.Z.); Department of Otolaryngology-Head & Neck Surgery, The Second Affiliated Hospital of Guilin Medical University, Guangxi, China (R.H.); Department of Ultrasound, Traditional Chinese Medical Hospital of Xinjiang, Xinjiang, China (Y.M.); Department of Pathology, First Medical Center of Chinese PLA General Hospital, Beijing, China (X.G.); and Department of Pathology, Affiliated Hospital of Hebei Engineering University, Hebei, China (Y.Z.)
| | - XiaoHui Zhou
- From the Department of Interventional Ultrasound, Fifth Medical Center of Chinese PLA General Hospital, 28 Fuxing Road, Beijing 100853, China (J.L., J.Y., P.L.); Department of Ultrasound, The First Affiliated Hospital of Henan University of CM, Henan, China (C.L.); Department of Ultrasound Diagnostics, The Affiliated Changsha Central Hospital, Hengyang Medical School, University of South China, Hunan, China (X.Z.); Department of Ultrasound, Peking University Third Hospital, Beijing, China (J.H.); Department of Ultrasound, Beijing Friendship Hospital, Capital Medical University, Beijing, China (P.Y.); Department of Otolaryngology Head and Neck Surgery, Chinese PLA General Hospital, Beijing, China (Y.C.); Department of Ultrasound, Tianjin Medical University General Hospital, Tianjin, China (H.Z.); Department of Otolaryngology-Head & Neck Surgery, The Second Affiliated Hospital of Guilin Medical University, Guangxi, China (R.H.); Department of Ultrasound, Traditional Chinese Medical Hospital of Xinjiang, Xinjiang, China (Y.M.); Department of Pathology, First Medical Center of Chinese PLA General Hospital, Beijing, China (X.G.); and Department of Pathology, Affiliated Hospital of Hebei Engineering University, Hebei, China (Y.Z.)
| | - JiuPing Huang
- From the Department of Interventional Ultrasound, Fifth Medical Center of Chinese PLA General Hospital, 28 Fuxing Road, Beijing 100853, China (J.L., J.Y., P.L.); Department of Ultrasound, The First Affiliated Hospital of Henan University of CM, Henan, China (C.L.); Department of Ultrasound Diagnostics, The Affiliated Changsha Central Hospital, Hengyang Medical School, University of South China, Hunan, China (X.Z.); Department of Ultrasound, Peking University Third Hospital, Beijing, China (J.H.); Department of Ultrasound, Beijing Friendship Hospital, Capital Medical University, Beijing, China (P.Y.); Department of Otolaryngology Head and Neck Surgery, Chinese PLA General Hospital, Beijing, China (Y.C.); Department of Ultrasound, Tianjin Medical University General Hospital, Tianjin, China (H.Z.); Department of Otolaryngology-Head & Neck Surgery, The Second Affiliated Hospital of Guilin Medical University, Guangxi, China (R.H.); Department of Ultrasound, Traditional Chinese Medical Hospital of Xinjiang, Xinjiang, China (Y.M.); Department of Pathology, First Medical Center of Chinese PLA General Hospital, Beijing, China (X.G.); and Department of Pathology, Affiliated Hospital of Hebei Engineering University, Hebei, China (Y.Z.)
| | - Peipei Yang
- From the Department of Interventional Ultrasound, Fifth Medical Center of Chinese PLA General Hospital, 28 Fuxing Road, Beijing 100853, China (J.L., J.Y., P.L.); Department of Ultrasound, The First Affiliated Hospital of Henan University of CM, Henan, China (C.L.); Department of Ultrasound Diagnostics, The Affiliated Changsha Central Hospital, Hengyang Medical School, University of South China, Hunan, China (X.Z.); Department of Ultrasound, Peking University Third Hospital, Beijing, China (J.H.); Department of Ultrasound, Beijing Friendship Hospital, Capital Medical University, Beijing, China (P.Y.); Department of Otolaryngology Head and Neck Surgery, Chinese PLA General Hospital, Beijing, China (Y.C.); Department of Ultrasound, Tianjin Medical University General Hospital, Tianjin, China (H.Z.); Department of Otolaryngology-Head & Neck Surgery, The Second Affiliated Hospital of Guilin Medical University, Guangxi, China (R.H.); Department of Ultrasound, Traditional Chinese Medical Hospital of Xinjiang, Xinjiang, China (Y.M.); Department of Pathology, First Medical Center of Chinese PLA General Hospital, Beijing, China (X.G.); and Department of Pathology, Affiliated Hospital of Hebei Engineering University, Hebei, China (Y.Z.)
| | - Yuancheng Cang
- From the Department of Interventional Ultrasound, Fifth Medical Center of Chinese PLA General Hospital, 28 Fuxing Road, Beijing 100853, China (J.L., J.Y., P.L.); Department of Ultrasound, The First Affiliated Hospital of Henan University of CM, Henan, China (C.L.); Department of Ultrasound Diagnostics, The Affiliated Changsha Central Hospital, Hengyang Medical School, University of South China, Hunan, China (X.Z.); Department of Ultrasound, Peking University Third Hospital, Beijing, China (J.H.); Department of Ultrasound, Beijing Friendship Hospital, Capital Medical University, Beijing, China (P.Y.); Department of Otolaryngology Head and Neck Surgery, Chinese PLA General Hospital, Beijing, China (Y.C.); Department of Ultrasound, Tianjin Medical University General Hospital, Tianjin, China (H.Z.); Department of Otolaryngology-Head & Neck Surgery, The Second Affiliated Hospital of Guilin Medical University, Guangxi, China (R.H.); Department of Ultrasound, Traditional Chinese Medical Hospital of Xinjiang, Xinjiang, China (Y.M.); Department of Pathology, First Medical Center of Chinese PLA General Hospital, Beijing, China (X.G.); and Department of Pathology, Affiliated Hospital of Hebei Engineering University, Hebei, China (Y.Z.)
| | - Hongyan Zhai
- From the Department of Interventional Ultrasound, Fifth Medical Center of Chinese PLA General Hospital, 28 Fuxing Road, Beijing 100853, China (J.L., J.Y., P.L.); Department of Ultrasound, The First Affiliated Hospital of Henan University of CM, Henan, China (C.L.); Department of Ultrasound Diagnostics, The Affiliated Changsha Central Hospital, Hengyang Medical School, University of South China, Hunan, China (X.Z.); Department of Ultrasound, Peking University Third Hospital, Beijing, China (J.H.); Department of Ultrasound, Beijing Friendship Hospital, Capital Medical University, Beijing, China (P.Y.); Department of Otolaryngology Head and Neck Surgery, Chinese PLA General Hospital, Beijing, China (Y.C.); Department of Ultrasound, Tianjin Medical University General Hospital, Tianjin, China (H.Z.); Department of Otolaryngology-Head & Neck Surgery, The Second Affiliated Hospital of Guilin Medical University, Guangxi, China (R.H.); Department of Ultrasound, Traditional Chinese Medical Hospital of Xinjiang, Xinjiang, China (Y.M.); Department of Pathology, First Medical Center of Chinese PLA General Hospital, Beijing, China (X.G.); and Department of Pathology, Affiliated Hospital of Hebei Engineering University, Hebei, China (Y.Z.)
| | - RenXiang Huang
- From the Department of Interventional Ultrasound, Fifth Medical Center of Chinese PLA General Hospital, 28 Fuxing Road, Beijing 100853, China (J.L., J.Y., P.L.); Department of Ultrasound, The First Affiliated Hospital of Henan University of CM, Henan, China (C.L.); Department of Ultrasound Diagnostics, The Affiliated Changsha Central Hospital, Hengyang Medical School, University of South China, Hunan, China (X.Z.); Department of Ultrasound, Peking University Third Hospital, Beijing, China (J.H.); Department of Ultrasound, Beijing Friendship Hospital, Capital Medical University, Beijing, China (P.Y.); Department of Otolaryngology Head and Neck Surgery, Chinese PLA General Hospital, Beijing, China (Y.C.); Department of Ultrasound, Tianjin Medical University General Hospital, Tianjin, China (H.Z.); Department of Otolaryngology-Head & Neck Surgery, The Second Affiliated Hospital of Guilin Medical University, Guangxi, China (R.H.); Department of Ultrasound, Traditional Chinese Medical Hospital of Xinjiang, Xinjiang, China (Y.M.); Department of Pathology, First Medical Center of Chinese PLA General Hospital, Beijing, China (X.G.); and Department of Pathology, Affiliated Hospital of Hebei Engineering University, Hebei, China (Y.Z.)
| | - Yang Mu
- From the Department of Interventional Ultrasound, Fifth Medical Center of Chinese PLA General Hospital, 28 Fuxing Road, Beijing 100853, China (J.L., J.Y., P.L.); Department of Ultrasound, The First Affiliated Hospital of Henan University of CM, Henan, China (C.L.); Department of Ultrasound Diagnostics, The Affiliated Changsha Central Hospital, Hengyang Medical School, University of South China, Hunan, China (X.Z.); Department of Ultrasound, Peking University Third Hospital, Beijing, China (J.H.); Department of Ultrasound, Beijing Friendship Hospital, Capital Medical University, Beijing, China (P.Y.); Department of Otolaryngology Head and Neck Surgery, Chinese PLA General Hospital, Beijing, China (Y.C.); Department of Ultrasound, Tianjin Medical University General Hospital, Tianjin, China (H.Z.); Department of Otolaryngology-Head & Neck Surgery, The Second Affiliated Hospital of Guilin Medical University, Guangxi, China (R.H.); Department of Ultrasound, Traditional Chinese Medical Hospital of Xinjiang, Xinjiang, China (Y.M.); Department of Pathology, First Medical Center of Chinese PLA General Hospital, Beijing, China (X.G.); and Department of Pathology, Affiliated Hospital of Hebei Engineering University, Hebei, China (Y.Z.)
| | - Xiangnan Gou
- From the Department of Interventional Ultrasound, Fifth Medical Center of Chinese PLA General Hospital, 28 Fuxing Road, Beijing 100853, China (J.L., J.Y., P.L.); Department of Ultrasound, The First Affiliated Hospital of Henan University of CM, Henan, China (C.L.); Department of Ultrasound Diagnostics, The Affiliated Changsha Central Hospital, Hengyang Medical School, University of South China, Hunan, China (X.Z.); Department of Ultrasound, Peking University Third Hospital, Beijing, China (J.H.); Department of Ultrasound, Beijing Friendship Hospital, Capital Medical University, Beijing, China (P.Y.); Department of Otolaryngology Head and Neck Surgery, Chinese PLA General Hospital, Beijing, China (Y.C.); Department of Ultrasound, Tianjin Medical University General Hospital, Tianjin, China (H.Z.); Department of Otolaryngology-Head & Neck Surgery, The Second Affiliated Hospital of Guilin Medical University, Guangxi, China (R.H.); Department of Ultrasound, Traditional Chinese Medical Hospital of Xinjiang, Xinjiang, China (Y.M.); Department of Pathology, First Medical Center of Chinese PLA General Hospital, Beijing, China (X.G.); and Department of Pathology, Affiliated Hospital of Hebei Engineering University, Hebei, China (Y.Z.)
| | - Yang Zhang
- From the Department of Interventional Ultrasound, Fifth Medical Center of Chinese PLA General Hospital, 28 Fuxing Road, Beijing 100853, China (J.L., J.Y., P.L.); Department of Ultrasound, The First Affiliated Hospital of Henan University of CM, Henan, China (C.L.); Department of Ultrasound Diagnostics, The Affiliated Changsha Central Hospital, Hengyang Medical School, University of South China, Hunan, China (X.Z.); Department of Ultrasound, Peking University Third Hospital, Beijing, China (J.H.); Department of Ultrasound, Beijing Friendship Hospital, Capital Medical University, Beijing, China (P.Y.); Department of Otolaryngology Head and Neck Surgery, Chinese PLA General Hospital, Beijing, China (Y.C.); Department of Ultrasound, Tianjin Medical University General Hospital, Tianjin, China (H.Z.); Department of Otolaryngology-Head & Neck Surgery, The Second Affiliated Hospital of Guilin Medical University, Guangxi, China (R.H.); Department of Ultrasound, Traditional Chinese Medical Hospital of Xinjiang, Xinjiang, China (Y.M.); Department of Pathology, First Medical Center of Chinese PLA General Hospital, Beijing, China (X.G.); and Department of Pathology, Affiliated Hospital of Hebei Engineering University, Hebei, China (Y.Z.)
| | - Jie Yu
- From the Department of Interventional Ultrasound, Fifth Medical Center of Chinese PLA General Hospital, 28 Fuxing Road, Beijing 100853, China (J.L., J.Y., P.L.); Department of Ultrasound, The First Affiliated Hospital of Henan University of CM, Henan, China (C.L.); Department of Ultrasound Diagnostics, The Affiliated Changsha Central Hospital, Hengyang Medical School, University of South China, Hunan, China (X.Z.); Department of Ultrasound, Peking University Third Hospital, Beijing, China (J.H.); Department of Ultrasound, Beijing Friendship Hospital, Capital Medical University, Beijing, China (P.Y.); Department of Otolaryngology Head and Neck Surgery, Chinese PLA General Hospital, Beijing, China (Y.C.); Department of Ultrasound, Tianjin Medical University General Hospital, Tianjin, China (H.Z.); Department of Otolaryngology-Head & Neck Surgery, The Second Affiliated Hospital of Guilin Medical University, Guangxi, China (R.H.); Department of Ultrasound, Traditional Chinese Medical Hospital of Xinjiang, Xinjiang, China (Y.M.); Department of Pathology, First Medical Center of Chinese PLA General Hospital, Beijing, China (X.G.); and Department of Pathology, Affiliated Hospital of Hebei Engineering University, Hebei, China (Y.Z.)
| | - Ping Liang
- From the Department of Interventional Ultrasound, Fifth Medical Center of Chinese PLA General Hospital, 28 Fuxing Road, Beijing 100853, China (J.L., J.Y., P.L.); Department of Ultrasound, The First Affiliated Hospital of Henan University of CM, Henan, China (C.L.); Department of Ultrasound Diagnostics, The Affiliated Changsha Central Hospital, Hengyang Medical School, University of South China, Hunan, China (X.Z.); Department of Ultrasound, Peking University Third Hospital, Beijing, China (J.H.); Department of Ultrasound, Beijing Friendship Hospital, Capital Medical University, Beijing, China (P.Y.); Department of Otolaryngology Head and Neck Surgery, Chinese PLA General Hospital, Beijing, China (Y.C.); Department of Ultrasound, Tianjin Medical University General Hospital, Tianjin, China (H.Z.); Department of Otolaryngology-Head & Neck Surgery, The Second Affiliated Hospital of Guilin Medical University, Guangxi, China (R.H.); Department of Ultrasound, Traditional Chinese Medical Hospital of Xinjiang, Xinjiang, China (Y.M.); Department of Pathology, First Medical Center of Chinese PLA General Hospital, Beijing, China (X.G.); and Department of Pathology, Affiliated Hospital of Hebei Engineering University, Hebei, China (Y.Z.)
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Qiu Y, Xing Z, Yang Q, Luo Y, Ma B. Diagnostic performance of shear wave elastography in thyroid nodules with indeterminate cytology: A systematic review and meta-analysis. Heliyon 2023; 9:e20654. [PMID: 37842563 PMCID: PMC10570586 DOI: 10.1016/j.heliyon.2023.e20654] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Revised: 09/24/2023] [Accepted: 10/03/2023] [Indexed: 10/17/2023] Open
Abstract
Purpose Thyroid nodules classified as indeterminate in previous fine-needle aspiration cytology often necessitate additional evaluation to determine their histology, while shear wave elastography (SWE) offers an alternative option in this regard. The objective of this study was to assess the diagnostic effectiveness of SWE in evaluating indeterminate nodules. Methods The PubMed, EMBASE, and Web of Science databases were searched from 1st January 1970 to 1st March 2023. The studies were reviewed and the data was extracted by two separate reviewers. A Bayesian bivariate model was utilized to quantitatively synthesize the diagnostic accuracy and yield of the studies in R. Results A total of seven studies, involving indeterminate thyroid nodules undergoing SWE were included, and the overall malignancy rate was 34.1% (307/900). The summarized estimates of sensitivity and specificity were 0.792 (95% credible interval [CI], 0.727-0.850) and 0.845 (95% CI, 0.797-0.887), respectively. The summarized estimate for the diagnostic odds ratio (DOR) was 17.8 (95% CI, 14.0-22.6). Summarized receiver operating characteristic (SROC) plots indicated a trade-off between sensitivity and specificity, and the estimate of AUC was 0.866 (95% CI, 0.834-0.895). The summary estimates for positive and negative likelihood ratios were 4.67 (95% CI, 3.98-5.85) and 0.26 (95% CI, 0.23-0.28), respectively. Conclusions The overall accuracy of SWE remains satisfactory in indeterminate thyroid nodules. However, it should be noted that the available data are still extremely limited, and more studies or guidelines are required to provide further insights.
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Affiliation(s)
- Yuxuan Qiu
- Department of Ultrasound, West China Hospital, Sichuan University, Chengdu, China
- Department of Thyroid & Parathyroid Surgery, West China Hospital, Sichuan University, Chengdu, China
| | - Zhichao Xing
- Department of Thyroid & Parathyroid Surgery, West China Hospital, Sichuan University, Chengdu, China
| | - Qianru Yang
- Department of Ultrasound, West China Hospital, Sichuan University, Chengdu, China
| | - Yan Luo
- Department of Ultrasound, West China Hospital, Sichuan University, Chengdu, China
| | - Buyun Ma
- Department of Ultrasound, West China Hospital, Sichuan University, Chengdu, China
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Li HJ, Yang YP, Liang X, Zhang Z, Xu XH. Comparison of the diagnostic performance of three ultrasound thyroid nodule risk stratification systems for follicular thyroid neoplasm: K-TIRADS, ACR -TIRADS and C-TIRADS. Clin Hemorheol Microcirc 2023; 85:395-406. [PMID: 37694360 DOI: 10.3233/ch-231898] [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: 09/12/2023]
Abstract
OBJECTIVE To explore the diagnostic performance of the currently used ultrasound-based thyroid nodule risk stratification systems (K-TIRADS, ACR -TIRADS, and C-TIRADS) in differentiating follicular thyroid adenoma (FTA) from follicular thyroid carcinoma (FTC). METHODS Clinical data and preoperative ultrasonographic images of 269 follicular thyroid neoplasms were retrospectively analyzed. All of them were detected by Color Doppler ultrasound instruments equipped with high-frequency liner array probes (e.g. Toshiba Apoli500 with L5-14MHZ; Philips IU22 with L5-12MHZ; GE LOGIQ E9 with L9-12MHZ and MyLab Class C with L9-14MHZ). The diagnostic performance of three TIRADS classifications for differentiating FTA from FTC was evaluated by drawing the receiver operating characteristic (ROC) curves and calculating the cut-off values. RESULTS Of the 269 follicular neoplasms (mean size, 3.67±1.53 cm), 209 were FTAs (mean size, 3.56±1.38 cm) and 60 were FTCs (mean size, 4.07±1.93 cm). There were significant differences in ultrasound features such as margins, calcifications, and vascularity of thyroid nodules between the FTA and FTC groups (P < 0.05). According to the ROC curve comparison analysis, the diagnostic cut-off values of K-TIRADS, ACR-TIRADS, and C-TIRADS for identifying FTA and FTC were K-TR4, ACR-TR4, and C-TR4B, respectively, and the areas under the curves were 0.676, 0.728, and 0.719, respectively. The difference between ACR-TIRADS and K-TIRADS classification was statistically significant (P = 0.0241), whereas the differences between ACR-TIRADS and C-TIRADS classification and between K-TIRADS and C-TIRADS classification were not statistically significant (P > 0.05). CONCLUSION The three TIRADS classifications were not conducive to distinguishing FTA from FTC. It is necessary to develop a novel malignant risk stratification system specifically for the identification of follicular thyroid neoplasms.
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Affiliation(s)
- Hua-Juan Li
- Department of Ultrasound, Affiliated Hospital of Guangdong Medical University, Zhanjiang, China
| | - Yu-Ping Yang
- Department of Ultrasound, Affiliated Hospital of Guangdong Medical University, Zhanjiang, China
| | - Xin Liang
- Department of Ultrasound, Affiliated Hospital of Guangdong Medical University, Zhanjiang, China
| | - Zhi Zhang
- Department of Thyroid and Mammary Vascular Surgery, Affiliated Hospital of Guangdong Medical University, Zhanjiang, China
| | - Xiao-Hong Xu
- Department of Ultrasound, Affiliated Hospital of Guangdong Medical University, Zhanjiang, China
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Wu SJ, Tan L, Ruan JL, Qiu Y, Hao SY, Yang HY, Luo BM. ACR TI-RADS classification combined with number of nodules, halo features optimizes diagnosis and prediction of follicular thyroid cancer. Clin Hemorheol Microcirc 2022; 82:323-334. [PMID: 36093690 DOI: 10.3233/ch-221507] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
OBJECTIVES To investigate the application value of The American College of Radiology (ACR) Thyroid Imaging Reporting and Data System (TI-RADS) category combined with other ultrasound features of nodules in distinguishing follicular thyroid carcinoma (FTC) from thyroid follicular adenoma (FTA). METHODS We collected and retrospectively analyzed clinical and ultrasound data for 118 and 459 patients with FTCs and FTAs, respectively, at our hospital. Next, we used ACR TI-RADS classification combined with other ultrasound features of nodules to distinguish FTC from FTA. Multivariate Logistic regression was used to screen independent risk factors for FTC, which were subsequently used to construct a nomogram for predicting FTC. RESULTS ACR TI-RADS categories 4 and 5, unilateral multiple nodules, and halo thickness≥2 mm were independent risk factors for FTC. ACR TI-RADS category combined with number of nodules, halo features of the nodule was a significantly better prediction model for FTC diagnosis (AUC = 0.869) than that of ACR TI-RADS classification alone (AUC = 0.756). CONCLUTIONS Clinicians need to pay attention to the halo of nodules when distinguishing FTA from FTC. Notably, ACR TI-RADS combined with other nodule ultrasound features has superior predictive performance in diagnosis of FTC compared to ACR TI-RADS classification alone, thus can provide an important reference value for preoperative diagnosis of FTC.
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Affiliation(s)
- Shi-Ji Wu
- Department of Ultrasound, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, No. 107 Yanjiang Road West, Guangzhou 510120, China.,Department of Ultrasound, the First People's Hospital of Kashi Prefecture, No. 120 Yingbin Avenue, Kashi, Xinjiang 844000, China
| | - Long Tan
- Department of Ultrasound, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, No. 107 Yanjiang Road West, Guangzhou 510120, China
| | - Jing-Liang Ruan
- Department of Ultrasound, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, No. 107 Yanjiang Road West, Guangzhou 510120, China
| | - Ya Qiu
- Department of Radiology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, No. 107Yanjiang Road West, Guangzhou 510120, China.,Department of Radiology, the First People's Hospital of Kashi Prefecture, No. 120 YingbinAvenue, Kashi, Xinjiang 844000, China
| | - Shao-Yun Hao
- Department of Ultrasound, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, No. 107 Yanjiang Road West, Guangzhou 510120, China
| | - Hai-Yun Yang
- Department of Ultrasound, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, No. 107 Yanjiang Road West, Guangzhou 510120, China
| | - Bao-Ming Luo
- Department of Ultrasound, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, No. 107 Yanjiang Road West, Guangzhou 510120, China
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9
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Yang J, Sun Y, Li X, Zhao Y, Han X, Chen G, Ding W, Li R, Wang J, Xiao F, Liu C, Xu S. Diagnostic performance of six ultrasound-based risk stratification systems in thyroid follicular neoplasm: A retrospective multi-center study. Front Oncol 2022; 12:1013410. [PMID: 36338713 PMCID: PMC9632336 DOI: 10.3389/fonc.2022.1013410] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2022] [Accepted: 10/06/2022] [Indexed: 12/07/2022] Open
Abstract
This study aimed to compare the diagnostic performances of six commonly used ultrasound-based risk stratification systems for distinguishing follicular thyroid adenoma (FTA) from follicular thyroid carcinoma (FTC), including the American Thyroid Association Sonographic Pattern System (ATASPS), ultrasound classification systems proposed by American Association of Clinical Endocrinologists, American College of Endocrinology, and Associazione Medici Endocrinology (AACE/ACE/AME), Korean thyroid imaging reporting and data system (K-TIRADS), European Thyroid Association for the imaging reporting and data system (EU-TIRADS), American College of Radiology for the imaging reporting and data system (ACR-TIRADS), and 2020 Chinese Guidelines for Ultrasound Malignancy Risk Stratification of Thyroid Nodules (C-TIRADS). A total of 225 FTA or FTC patients were retrospectively analyzed, involving 251 thyroid nodules diagnosed by postoperative pathological examinations in three centers from January 2013 to October 2021. The diagnostic performances of six ultrasound-based risk stratification systems for distinguishing FTA from FTC were assessed by plotting the receiver operating characteristic (ROC) curves and compared at different cut-off values. A total of 205 (81.67%) cases of FTA and 46 (18.33%) cases of FTC were involved in the present study. Compared with those of FTA, FTC presented more typical ultrasound features of solid component, hypoechoic, irregular margin and sonographic halo (all P<0.001). There were no significant differences in ultrasound features of calcification, shape and comet-tail artifacts between cases of FTA and FTC. There was a significant difference in the category of thyroid nodules assessed by the six ultrasound-based risk stratification systems (P<0.001). The areas under the curve (AUCs) of ATASPS, AACE/ACE/AME, K-TIRADS, EU-TIRADS, ACR-TIRADS and C-TIRADS in distinguishing FTA from FTC were 0.645, 0.729, 0.766, 0.635, 0.783 and 0.798, respectively. Our study demonstrated that all the six ultrasound-based risk stratification systems present potential in the differential diagnosis of FTA and FTC. Specifically, C-TIRADS exerts the best diagnostic performance among the Chinese patients. ATASPS possesses a high sensitivity, while K-TIRADS possesses a high specificity in distinguishing FTA from FTC.
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Affiliation(s)
- Jingjing Yang
- Endocrine and Diabetes Center, Affiliated Hospital of Integrated Traditional Chinese and Western Medicine, Jiangsu Province Academy of Traditional Chinese Medicine, Nanjing University of Chinese Medicine, Nanjing, China
| | - Yu Sun
- Endocrine and Diabetes Center, Affiliated Hospital of Integrated Traditional Chinese and Western Medicine, Jiangsu Province Academy of Traditional Chinese Medicine, Nanjing University of Chinese Medicine, Nanjing, China
- Department of Endocrinology and Metabolism, The Affiliated Suqian Hospital of Xuzhou Medical University, Suqian, China
| | - Xingjia Li
- Endocrine and Diabetes Center, Affiliated Hospital of Integrated Traditional Chinese and Western Medicine, Jiangsu Province Academy of Traditional Chinese Medicine, Nanjing University of Chinese Medicine, Nanjing, China
- Key Laboratory of Traditional Chinese Medicine (TCM) Syndrome and Treatment of Yingbing of State Administration of Traditional Chinese Medicine, Jiangsu Province Academy of Traditional Chinese Medicine, Nanjing, China
| | - Yueting Zhao
- Endocrine and Diabetes Center, Affiliated Hospital of Integrated Traditional Chinese and Western Medicine, Jiangsu Province Academy of Traditional Chinese Medicine, Nanjing University of Chinese Medicine, Nanjing, China
| | - Xue Han
- Endocrine and Diabetes Center, Affiliated Hospital of Integrated Traditional Chinese and Western Medicine, Jiangsu Province Academy of Traditional Chinese Medicine, Nanjing University of Chinese Medicine, Nanjing, China
| | - Guofang Chen
- Endocrine and Diabetes Center, Affiliated Hospital of Integrated Traditional Chinese and Western Medicine, Jiangsu Province Academy of Traditional Chinese Medicine, Nanjing University of Chinese Medicine, Nanjing, China
- Key Laboratory of Traditional Chinese Medicine (TCM) Syndrome and Treatment of Yingbing of State Administration of Traditional Chinese Medicine, Jiangsu Province Academy of Traditional Chinese Medicine, Nanjing, China
| | - Wenbo Ding
- Department of Ultrasound, Affiliated Hospital of Integrated Traditional Chinese and Western Medicine, Nanjing University of Chinese Medicine, Nanjing, China
| | - Ruiping Li
- Department of Pathology, Affiliated Hospital of Integrated Traditional Chinese and Western Medicine, Nanjing University of Chinese Medicine, Nanjing, China
| | - Jianhua Wang
- Department of General Surgery, Affiliated Hospital of Integrated Traditional Chinese and Western Medicine, Nanjing University of Chinese Medicine, Nanjing, China
| | - Fangsen Xiao
- Department of Endocrinology and Diabetes, The First Affiliated Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, China
- *Correspondence: Shuhang Xu, ; Fangsen Xiao,
| | - Chao Liu
- Endocrine and Diabetes Center, Affiliated Hospital of Integrated Traditional Chinese and Western Medicine, Jiangsu Province Academy of Traditional Chinese Medicine, Nanjing University of Chinese Medicine, Nanjing, China
- Key Laboratory of Traditional Chinese Medicine (TCM) Syndrome and Treatment of Yingbing of State Administration of Traditional Chinese Medicine, Jiangsu Province Academy of Traditional Chinese Medicine, Nanjing, China
| | - Shuhang Xu
- Endocrine and Diabetes Center, Affiliated Hospital of Integrated Traditional Chinese and Western Medicine, Jiangsu Province Academy of Traditional Chinese Medicine, Nanjing University of Chinese Medicine, Nanjing, China
- *Correspondence: Shuhang Xu, ; Fangsen Xiao,
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10
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Lin Y, Lai S, Wang P, Li J, Chen Z, Wang L, Guan H, Kuang J. Performance of current ultrasound-based malignancy risk stratification systems for thyroid nodules in patients with follicular neoplasms. Eur Radiol 2022; 32:3617-3630. [PMID: 34973102 PMCID: PMC9122875 DOI: 10.1007/s00330-021-08450-3] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2021] [Revised: 10/28/2021] [Accepted: 10/29/2021] [Indexed: 02/05/2023]
Abstract
OBJECTIVES To investigate the ability of the currently used ultrasound-based malignancy risk stratification systems for thyroid neoplasms (ATA, AACE/ACE/AME, K-TIRADS, EU-TIRADS, ACR-TIRADS and C-TIRADS) in distinguishing follicular thyroid carcinoma (FTC) from follicular thyroid adenoma (FTA). Additionally, we evaluated the ability of these systems in correctly determining the indication for biopsy. METHODS Three hundred twenty-nine follicular neoplasms with definitive postoperative histopathology were included. The nodules were categorized according to each of six stratification systems, based on ultrasound findings. We dichotomized nodules into the positive predictive group of FTC (high and intermediate risk) and negative group of FTC based on the classification results. Missed biopsy was defined as neoplasms that were diagnosed as FTCs but for which biopsy was not indicated based on lesion classification. Unnecessary biopsy was defined as neoplasms that were diagnosed as FTAs but for whom biopsy was considered indicated based on classification. The diagnostic performance and missed and unnecessary biopsy rates were evaluated for each stratification system. RESULTS The area under the curve of each system for distinguishing follicular neoplasms was < 0.700 (range, 0.511-0.611). The missed biopsy rates were 9.0-22.4%. The missed biopsy rates for lesions ≤ 4 cm and lesions sized 2-4 cm were 16.2-35.1% and 0-20.0%, respectively. Unnecessary biopsy rates were 65.3-93.1%. In ≤ 4 cm group, the unnecessary biopsy rates were 62.2-89.7%. CONCLUSION The malignancy risk stratification systems can select appropriate nodules for biopsy in follicular neoplasms, while they have limitations in distinguishing follicular neoplasms and reducing unnecessary biopsy. Specific stratification systems and recommendations should be established for follicular neoplasms. KEY POINTS • Current ultrasound-based malignancy risk stratification systems of thyroid nodules had low efficiency in the characterization of follicular neoplasms. • The adopted stratification systems showed acceptable performance for selecting FTC for biopsy but unsatisfactory performance for reducing unnecessary biopsy.
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Affiliation(s)
- Yinghe Lin
- Department of Endocrinology, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong, China
- The Second School of Clinical Medicine, Southern Medical University, Guangzhou, Guangdong, China
| | - Shuiqing Lai
- Department of Endocrinology, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong, China
| | - Peiqing Wang
- Department of Endocrinology, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong, China
- Shantou University Medical College, Shantou, Guangdong, China
| | - Jinlian Li
- Department of Endocrinology, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong, China
- The Second School of Clinical Medicine, Southern Medical University, Guangzhou, Guangdong, China
| | - Zhijiang Chen
- Department of Endocrinology, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong, China
| | - Long Wang
- Department of Endocrinology, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong, China
| | - Haixia Guan
- Department of Endocrinology, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong, China.
| | - Jian Kuang
- Department of Endocrinology, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong, China.
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Cao J, Huang W, Huang P, Huang Y. ACR TI-RADS and ATA ultrasound classifications are helpful for the management of thyroid nodules located in the isthmus. Clin Hemorheol Microcirc 2021; 80:463-471. [PMID: 34864651 DOI: 10.3233/ch-211304] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
PURPOSE To compare the application value of the American College of Radiology (ACR) Thyroid Imaging Reporting and Data System (TI-RADS) and the American Thyroid Association (ATA) guidelines in the risk stratification of thyroid isthmic nodules. METHODS A total of 315 patients with thyroid isthmic nodules (315 nodules) confirmed by surgical pathology or fine-needle aspiration biopsy (FNAB) were selected in this retrospective study. The nodules were evaluated and classified according to ACR TI-RADS and the ATA guidelines. Taking pathological results as the reference, receiver operating characteristic (ROC) curves were drawn to evaluate the diagnostic capabilities of the ACR TI-RADS and the ATA guidelines for the risk stratification of thyroid isthmic nodules. The unnecessary biopsy rates and false-negative rates were compared. RESULTS Multivariate analysis of ultrasonographic features of suspicious malignancies showed that an aspect ratio > 1 was not an independent risk factor for malignant thyroid nodules located in the isthmus (odds ratio: 3.193, 95%confidence interval: 0.882-11.552) (P = 0.077). The area under the ROC curves for diagnosing malignant thyroid nodules located in the isthmus in by the ACR TI-RADS and the ATA guidelines were 0.853 and 0.835, respectively. Under the management recommendations of the ACR TI-RADS and ATA guidelines, the false-negative rates of malignant thyroid nodules were 66.2%(ATA intermediate suspicion), 62.3%(ACR TR 4), 81.8%(ATA high suspicion) and 86.5%(ACR TR 5). CONCLUSION Both the ACR TI-RADS and the ATA guidelines have high diagnostic capabilities for the risk stratification of thyroid isthmic nodules. For ACR TR 4 and 5 and ATA intermediate- and high-suspicion thyroid isthmic nodules with a maximum diameter < 1 cm, the criteria for puncture should be lowered, and FNAB should be done to clarify their diagnosis.
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Affiliation(s)
- Jianhui Cao
- Department of Ultrasound, the Jiashan County First People's Hospital, Jiashan County, Zhejiang Province, China
| | - Weiwei Huang
- Department of Ultrasound, the Jiashan County First People's Hospital, Jiashan County, Zhejiang Province, China
| | - Pintong Huang
- Department of Ultrasound in Medicine, Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou City, Zhejiang Province, China
| | - Yunlin Huang
- Department of Ultrasound in Medicine, Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou City, Zhejiang Province, China
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12
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Huang Q, Xie L, Huang L, Wei W, Li H, Zhuang Y, Liu X, Chen S, Zhang S. Development and Validation of an Ultrasonic Diagnostic Model for Differentiating Follicular Thyroid Carcinoma from Follicular Adenoma. Int J Gen Med 2021; 14:5069-5078. [PMID: 34511989 PMCID: PMC8415765 DOI: 10.2147/ijgm.s331338] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Accepted: 08/24/2021] [Indexed: 12/07/2022] Open
Abstract
Background High-resolution ultrasound is the first choice for the diagnosis of thyroid nodules, but it is still difficult to distinguish between follicular thyroid carcinoma (FTC) and follicular adenoma (FA). Our research aimed to develop and validate an ultrasonic diagnostic model for differentiating FTC from FA. Methods This study retrospectively analyzed 196 patients who were diagnosed as FTC (n=83) and FA (n=113). LASSO regression analysis was used to screen clinical and ultrasonic features. Multivariate logistic regression analysis was used to establish the ultrasonic diagnostic model of FTC. Nomogram was used for the visualization of diagnostic models. C-index, ROC, and calibration curves analysis were used to evaluate the accuracy of the diagnostic model. Decision curve analysis (DCA) was used to evaluate the net benefits of the ultrasonic diagnostic model for FTC diagnosis under different threshold probabilities. The bootstrap method was used to verify the ultrasonic diagnostic model. Results After Lasso regression analysis, 10 clinical and ultrasonic features were used to construct the ultrasonic diagnostic model of FTC. The C-index and AUC of the model were 0.868 and 0.860, respectively. DCA showed that the ultrasonic model had good clinical application value. The C-index in the validation group was 0.818, which was close to the C-index in the model. Conclusion Ultrasonic diagnostic model constructed with 10 clinical and ultrasonic features can better distinguish FTC from FA.
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Affiliation(s)
- Qingshan Huang
- Musculoskeletal Tumor Center, Peking University People's Hospital, Beijing, 100044, People's Republic of China
| | - Lijun Xie
- Department of Ultrasound, The First Affiliated Hospital of Fujian Medical University, Fuzhou, 350005, People's Republic of China
| | - Liyan Huang
- Department of Ultrasound, The First Affiliated Hospital of Fujian Medical University, Fuzhou, 350005, People's Republic of China
| | - Weili Wei
- Department of Ultrasound, The First Affiliated Hospital of Fujian Medical University, Fuzhou, 350005, People's Republic of China
| | - Haiying Li
- Department of Ultrasound, The First Affiliated Hospital of Fujian Medical University, Fuzhou, 350005, People's Republic of China
| | - Yunfang Zhuang
- Department of Ultrasound, The First Affiliated Hospital of Fujian Medical University, Fuzhou, 350005, People's Republic of China
| | - Xinxiu Liu
- Department of Ultrasound, The First Affiliated Hospital of Fujian Medical University, Fuzhou, 350005, People's Republic of China
| | - Shuqiang Chen
- Department of Ultrasound, The First Affiliated Hospital of Fujian Medical University, Fuzhou, 350005, People's Republic of China
| | - Sufang Zhang
- Department of Ultrasound, The First Affiliated Hospital of Fujian Medical University, Fuzhou, 350005, People's Republic of China
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Peschel G, Grimm J, Buechler C, Gunckel M, Pollinger K, Aschenbrenner E, Kammerer S, Jung EM, Haimerl M, Werner J, Müller M, Weigand K. Liver stiffness assessed by shear-wave elastography declines in parallel with immunoregulatory proteins in patients with chronic HCV infection during DAA therapy. Clin Hemorheol Microcirc 2021; 79:541-555. [PMID: 34120896 DOI: 10.3233/ch-211193] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
BACKGROUND A rapid decline of liver stiffness (LS) was detected by non-invasive methods in patients with chronic hepatitis C (HCV) infection during treatment with direct-acting antivirals (DAA). OBJECTIVE To investigate the influence of inflammation on LS. METHODS We prospectively examined LS by sonographic shear-wave elastography in 217 patients during DAA therapy from treatment initiation (BL) to 12 weeks after end of therapy (SVR12). Demographic data, laboratory findings and serum levels of cytokines were determined. RESULTS Values of LS decreased from 1.86 m/s to 1.68 m/s (p = 0.01) which was most pronounced in patients who had F4 fibrosis at BL (3.27 m/s to 2.37 m/s; p < 0.001). Initially elevated values of aminotransferases, ferritin, IgG (p < 0.001 each) and international normalized ratio (p < 0.003) declined, thrombocyte count (p = 0.007) increased. Correlations of these laboratory parameters with BL levels of LS measurement (LSM) were most apparent in patients with F1-F3 fibrosis. Tumor necrosis factor (TNF)-α (p = 0.031), interleukin (IL)-10 (p = 0.005) and interferon y inducible protein (IP)-10 (p < 0.001) decreased in parallel with LSM under DAA therapy and corelated with BL values. CONCLUSION Decrease of systemic inflammatory parameters correlated with LSM under DAA therapy. We conclude that regression of LSM is attributable to the decline of inflammation rather than reflecting fibrosis.
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Affiliation(s)
- G Peschel
- Department of Gastroenterology, Endocrinology, Rheumatology and Infectious Diseases, University Hospital Regensburg, Regensburg, Germany
| | - J Grimm
- Department of Gastroenterology, Endocrinology, Rheumatology and Infectious Diseases, University Hospital Regensburg, Regensburg, Germany
| | - C Buechler
- Department of Gastroenterology, Endocrinology, Rheumatology and Infectious Diseases, University Hospital Regensburg, Regensburg, Germany
| | - M Gunckel
- Department of Gastroenterology, Endocrinology, Rheumatology and Infectious Diseases, University Hospital Regensburg, Regensburg, Germany
| | - K Pollinger
- Department of Gastroenterology, Endocrinology, Rheumatology and Infectious Diseases, University Hospital Regensburg, Regensburg, Germany
| | - E Aschenbrenner
- Department of Gastroenterology, Endocrinology, Rheumatology and Infectious Diseases, University Hospital Regensburg, Regensburg, Germany
| | - S Kammerer
- Department of Radiology, University Hospital Regensburg, Regensburg, Germany
| | - E M Jung
- Department of Radiology, University Hospital Regensburg, Regensburg, Germany
| | - M Haimerl
- Department of Radiology, University Hospital Regensburg, Regensburg, Germany
| | - J Werner
- Department of Surgery, University Hospital Regensburg, Regensburg, Germany
| | - M Müller
- Department of Gastroenterology, Endocrinology, Rheumatology and Infectious Diseases, University Hospital Regensburg, Regensburg, Germany
| | - K Weigand
- Department of Gastroenterology, Endocrinology, Rheumatology and Infectious Diseases, University Hospital Regensburg, Regensburg, Germany
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14
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Zhang S, Huang L, Huang Q, Wei W, Xie L, Zeng J, Gu Q, Chen L, Chen S. The Value of Relative Size in the Ultrasound Diagnosis of Follicular Thyroid Neoplasm. Int J Gen Med 2021; 14:2321-2328. [PMID: 34113162 PMCID: PMC8184232 DOI: 10.2147/ijgm.s313468] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Accepted: 05/17/2021] [Indexed: 12/07/2022] Open
Abstract
Purpose Ultrasonography as the first choice for thyroid nodules is still difficult to distinguish between solid follicular thyroid neoplasm (FTN) and solid nodular goiter (NG). We tried to investigate the value of relative size (M/S, M: the maximum diameter of target nodule, S: the maximum diameter of the largest of the remaining nodules) that may help to differentiate FTN from NG. Methods T test and chi-square test were used to retrospectively analyze the differences of the clinical and ultrasonographic characteristics between FTN and NG in 422 cases in our hospital. T test was used to analyze the difference of M/S value in the two kinds of nodules. ROC was used to evaluate the accuracy of M/S value in distinguishing the two. Results There were statistically significant differences in age, echogenicity, calcification, peripheral halo and blood supply between the two. The M/S value is not only significantly different in the two kinds of nodules but also can be used as a quantitative indicator to guide ultrasound diagnosis. ROC analysis showed that the cutoff point and AUC of M/S value were 1.94 and 0.709, respectively. Conclusion In the ultrasound diagnosis of multiple thyroid nodules, the M/S value can better distinguish FTN and NG. We need to be aware of FTN when the M/S value of the nodule is greater than 2.
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Affiliation(s)
- Sufang Zhang
- Department of Ultrasound, The First Affiliated Hospital of Fujian Medical University, Fuzhou, 350005, People's Republic of China
| | - Liyan Huang
- Department of Ultrasound, The First Affiliated Hospital of Fujian Medical University, Fuzhou, 350005, People's Republic of China
| | - Qingshan Huang
- Musculoskeletal Tumor Center, Peking University People's Hospital, Beijing, 100044, People's Republic of China
| | - Weili Wei
- Department of Ultrasound, The First Affiliated Hospital of Fujian Medical University, Fuzhou, 350005, People's Republic of China
| | - Lijun Xie
- Department of Ultrasound, The First Affiliated Hospital of Fujian Medical University, Fuzhou, 350005, People's Republic of China
| | - Jinshu Zeng
- Department of Ultrasound, The First Affiliated Hospital of Fujian Medical University, Fuzhou, 350005, People's Republic of China
| | - Qiuyang Gu
- Department of Ultrasound, The First Affiliated Hospital of Fujian Medical University, Fuzhou, 350005, People's Republic of China
| | - Ling Chen
- Department of Ultrasound, The First Affiliated Hospital of Fujian Medical University, Fuzhou, 350005, People's Republic of China
| | - Shuqiang Chen
- Department of Ultrasound, The First Affiliated Hospital of Fujian Medical University, Fuzhou, 350005, People's Republic of China
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15
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Li W, Song Q, Lan Y, Li J, Zhang Y, Yan L, Li Y, Zhang Y, Luo Y. The Value of Sonography in Distinguishing Follicular Thyroid Carcinoma from Adenoma. Cancer Manag Res 2021; 13:3991-4002. [PMID: 34040440 PMCID: PMC8139727 DOI: 10.2147/cmar.s307166] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2021] [Accepted: 04/22/2021] [Indexed: 12/29/2022] Open
Abstract
Purpose Differentiation between follicular thyroid carcinomas (FTCs) and follicular thyroid adenomas (FTAs) is difficult and the sonographic features of FTC are not yet fully established. The purpose of this study is to explore the sonographic features of FTC and the value of sonography in differentiating FTCs from FTAs. Patients and Methods A total of 28 pathologically proven FTCs and 53 FTAs in 78 patients who were performed thyroid surgery were included in this retrospective study. The sonographic features of each tumor including an interrupted halo, satellite nodule(s) with or without halo ring, local irregularity of margin and cluster of grapes sign were evaluated. A mode image of FTC halo was built up in our study. The frequencies of the sonographic features were compared by chi-square test or Fisher exact test between FTCs and FTAs. The relative risk of malignancy was assessed by logistic regression analysis. Results Logistic regression analysis showed that a thick, irregular and/or interrupted halo with or without satellite nodule(s), hypoechoic or marked hypoechoic echogenicity, a predominantly solid pattern, cluster of grapes sign, micro-or macro-calcifications, rim calcifications correlated with significant increases in relative risk for FTCs (odds ratio 11.48 (1.37-96.56), 6.74 (1.05-43.30), 17.51 (1.78-172.53), 9.55 (1.44-63.46), 9.36 (1.25-70.15) and 17.45 (1.04-292.65), respectively, p<0.05). Two new sonographic features, an interrupted halo and satellite nodule(s) with or without halo ring, can only be found in FTCs. Conclusion An interrupted halo and satellite nodule(s) with or without halo ring are specific sonographic features for FTCs. Sonography could play a role in differentiating follicular thyroid carcinoma from adenoma.
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Affiliation(s)
- Wen Li
- Department of Ultrasound, Medical School of Chinese PLA, Beijing, People's Republic of China.,Department of Ultrasound, The First Medical Center Chinese PLA General Hospital, Beijing, People's Republic of China
| | - Qing Song
- Department of Ultrasound, The First Medical Center Chinese PLA General Hospital, Beijing, People's Republic of China
| | - Yu Lan
- Department of Ultrasound, The First Medical Center Chinese PLA General Hospital, Beijing, People's Republic of China
| | - Jie Li
- Department of Pathology, The First Medical Center, Chinese PLA General Hospital, Beijing, People's Republic of China
| | - Ying Zhang
- Department of Ultrasound, The First Medical Center Chinese PLA General Hospital, Beijing, People's Republic of China
| | - Lin Yan
- Department of Ultrasound, The First Medical Center Chinese PLA General Hospital, Beijing, People's Republic of China
| | - Yingying Li
- Department of Ultrasound, The First Medical Center Chinese PLA General Hospital, Beijing, People's Republic of China
| | - Yan Zhang
- Department of Ultrasound, The First Medical Center Chinese PLA General Hospital, Beijing, People's Republic of China
| | - Yukun Luo
- Department of Ultrasound, The First Medical Center Chinese PLA General Hospital, Beijing, People's Republic of China
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16
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Sonographic Features Differentiating Follicular Thyroid Cancer from Follicular Adenoma-A Meta-Analysis. Cancers (Basel) 2021; 13:cancers13050938. [PMID: 33668130 PMCID: PMC7956257 DOI: 10.3390/cancers13050938] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2020] [Revised: 02/17/2021] [Accepted: 02/19/2021] [Indexed: 12/17/2022] Open
Abstract
Simple Summary The risk of thyroid malignancy assessment may include certain ultrasound features. The analysis is lacking for the differentiation of follicular thyroid adenomas and cancers (FTAs and FTCs). Our meta-analysis aimed to identify sonographic features suggesting malignancy in the case of follicular lesions, potentially differentiating FTA and FTC. Based on twenty studies describing sonographic features of 10,215 nodules, we found that the most crucial feature associated with an increased risk of FTC were tumor protrusion (odds ratios—OR = 10.19), microcalcifications or mixed type of calcifications: 6.09, irregular margins: 5.11, marked hypoechogenicity: 4.59, and irregular shape: 3.6. Abstract Certain ultrasound features are associated with an increased risk of thyroid malignancy. However, they were studied mainly in papillary thyroid cancers (PTCs); these results cannot be simply extrapolated for the differentiation of follicular thyroid adenomas and cancers (FTAs and FTCs). The aim of our study was to perform a meta-analysis to identify sonographic features suggesting malignancy in the case of follicular lesions, potentially differentiating FTA and FTC. We searched thirteen databases from January 2006 to December 2020 to find all relevant, full-text journal articles written in English. Analyses assessed the accuracy of malignancy detection in case of follicular lesions, potentially differentiating FTA and FTC included the odds ratio (OR), sensitivity, specificity, positive and negative predictive values. A random-effects model was used to summarize collected data. Twenty studies describing sonographic features of 10,215 nodules met the inclusion criteria. The highest overall ORs to increase the risk of malignancy were calculated for tumor protrusion (OR = 10.19; 95% confidence interval: 2.62–39.71), microcalcifications or mixed type of calcifications (coexisting micro and macrocalcifications): 6.09 (3.22–11.50), irregular margins: 5.11 (2.90–8.99), marked hypoechogenicity: 4.59 (3.23–6.54), and irregular shape: 3.6 (1.19–10.92). The most crucial feature associated with an increased risk of FTC is capsule protrusion, followed by the presence of calcifications, irrespectively of their type.
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17
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Zhang WB, Li JJ, Chen XY, He BL, Shen RH, Liu H, Chen J, He XF. SWE combined with ACR TI-RADS categories for malignancy risk stratification of thyroid nodules with indeterminate FNA cytology. Clin Hemorheol Microcirc 2021; 76:381-390. [PMID: 32675401 DOI: 10.3233/ch-200893] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
OBJECTIVES To compare the diagnostic efficacy of shear wave elastography (SWE) comnined with ACR TI-RADS categories for malignancy risk stratification of thyroid nodules with interminate FNA cytology. METHODS The clinical data, sonographic features, ACR TI-RADS grading and shear wave elastography images of 193 patients of surgical pathologically proven thyroid nodules with interminate FNA cytology were retrospectively analyzed. The diagnostic efficacy of ACR TI-RADS categories, the maximum Young's modulus (Emax) of SWE and the combination of the two were calculated respectively. RESULTS The ROC curves were drawn using surgical pathology results as the gold standard. The ROC curves indicated that the cut-off value of ACR TI-RADS and Emax of SWE was TR5 and 41.2 kPa respectively, and the area under the ROC curve (AUC) was 0.864 (95% CI: 0.879-0.934) and 0.858 (95% CI: 0.796-0.920) respectively. The diagnostic sensitivity, specificity and accuracy of ACR TI-RADS was 81.4% (127/156), 84.8% (31/37), and 81.9% (158/193), respectively. That of SWE Emax was 80.8% (126/156), 78.4% (29/37), and 80.3% (155/193), respectively. After SWE combined with ACR TI-RADS, the sensitivity, specificity and accuracy was 94.2% (147/156), 75.7% (28/37), and 90.7% (175/193), respectively. CONCLUSIONS ACR TI-RADS classification system and shear wave elastography had high diagnostic efficacy for thyroid nodules with interminate FNA cytology. The combination of the two could improve diagnostic sensitivity and accuracy, and could help to differentiate benign and malignant thyroid nodules with interminate FNA cytology.
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Affiliation(s)
- Wei-Bing Zhang
- Department of Medical Ultrasound, Jiangsu Provincial Corps Hospital, Chinese People's Armed Police Forces, Yangzhou, China
| | - Jing-Jing Li
- Department of Medical Ultrasound, Jiangsu Provincial Corps Hospital, Chinese People's Armed Police Forces, Yangzhou, China
| | - Xiang-Yong Chen
- Department of Special Diagnosis, Lushan Rehabilitation Medicine Center, Wuxi Joint Service Forces, Jiujiang, China
| | - Bei-Li He
- Department of Medical Ultrasound, Jiangsu Provincial Corps Hospital, Chinese People's Armed Police Forces, Yangzhou, China
| | - Rong-Hua Shen
- Department of Medical Ultrasound, Jiangsu Provincial Corps Hospital, Chinese People's Armed Police Forces, Yangzhou, China
| | - Hua Liu
- Department of Medical Ultrasound, Jiangsu Provincial Corps Hospital, Chinese People's Armed Police Forces, Yangzhou, China
| | - Jian Chen
- Department of Medical Ultrasound, Jiangsu Provincial Corps Hospital, Chinese People's Armed Police Forces, Yangzhou, China
| | - Xiao-Fei He
- Department of Medical Rehabilitation, Jiangsu Provincial Corps Hospital, Chinese People's Armed Police Forces, Yangzhou, China
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Lian KM, Lin T. Value of image-pro plus for assisting virtual touch tissue imaging in the diagnosis of thyroid nodules. Clin Hemorheol Microcirc 2021; 77:143-151. [PMID: 33185591 DOI: 10.3233/ch-200983] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
PURPOSE The value of virtual touch tissue imaging (VTI) with support of Image-Pro Plus (IPP) for diagnosing malignant thyroid tumors was assessed in the present study. METHODS In this retrospective study, we enrolled 160 patients with 198 thyroid nodules. TI-RADS, VTI grade, and VTI with support of IPP (VTI-IPP) were underwent for each nodule. With the pathological diagnosis as the gold standard, the receiver-operating characteristic curve (ROC) was drawn to evaluate the diagnostic performance of VTI-IPP, VTI, TI-RADS, VTI-IPP combinate with TI-RADS in thyroid carcinoma. RESULTS VTI-IPP score >2, VTI score >3, TI-RADS score >1, and VTI-IPP combine with TI-RADS score >4 expressed the highest diagnostic value for malignant thyroid nodules, the areas under the curve (AUC) were 0.939, 0.905, 0.925, and 0.967, respectively. The combination indicated the largest AUC, compared with VTI-IPP and TI-RADS, respectively (P = 0.0054 and 0.0009). The performance of VTI-IPP in diagnosing thyroid carcinomas was better than VTI (P = 0.0321). CONCLUSION Compare with VTI, VTI-IPP exhibited more excellent value in distinguishing between benign and malignant thyroid nodules. The value of malignant thyroid nodules diagnosis can be improved when VTI-IPP combines with TI-RADS.
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Affiliation(s)
- Kai-Mei Lian
- Department of Ultrasound, The First Affiliated Hospital of Shantou University Medical College, Shantou, Guangdong Province, P.R. China
| | - Teng Lin
- Department of Ultrasound, The First Affiliated Hospital of Shantou University Medical College, Shantou, Guangdong Province, P.R. China
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