Dataset Information

Ultrasound Real-Time Tissue Elastography Improves the Diagnostic Performance of the ACR Thyroid Imaging Reporting and Data System in Differentiating Malignant from Benign Thyroid Nodules: A Summary of 1525 Thyroid Nodules.

ABSTRACT: Background:To explore the correlation between the ultrasound elasticity score (ES) of real-time tissue elastography (RTE) and the malignant risk stratification of the Thyroid Imaging Reporting and Data System (TI-RADS) and to evaluate the added value of RTE to TI-RADS in differentiating malignant nodules from benign ones. Methods:A total of 1,498 patients (885 women and 613 men; mean age of 43.5?±?12.4 years) with 1,525 confirmed thyroid nodules (D?=?maximum diameter, D???2.5?cm) confirmed by fine-needle aspiration (FNA) and/or surgery were included. The nodules were divided into four groups based on their sizes (D???0.5?cm, 0.5?

SUBMITTER: Pei S

PROVIDER: S-EPMC7178472 | biostudies-literature | 2020

REPOSITORIES: biostudies-literature

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Ultrasound Real-Time Tissue Elastography Improves the Diagnostic Performance of the ACR Thyroid Imaging Reporting and Data System in Differentiating Malignant from Benign Thyroid Nodules: A Summary of 1525 Thyroid Nodules.

Pei Shufang S Zhang Bin B Cong Shuzhen S Liu Juanjuan J Wu Suqing S Dong Yuhao Y Zhang Lu L Zhang Shuixing S

International journal of endocrinology 20200414

<h4>Background</h4>To explore the correlation between the ultrasound elasticity score (ES) of real-time tissue elastography (RTE) and the malignant risk stratification of the Thyroid Imaging Reporting and Data System (TI-RADS) and to evaluate the added value of RTE to TI-RADS in differentiating malignant nodules from benign ones.<h4>Methods</h4>A total of 1,498 patients (885 women and 613 men; mean age of 43.5 ± 12.4 years) with 1,525 confirmed thyroid nodules (<i>D</i> = maximum diameter, <i>D< ...[more]

PMID: 32351557

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Project description:BackgroundThe contrasted-enhanced ultrasound thyroid imaging reporting and data system (CEUS TI-RADS) is the first international risk stratification system for thyroid nodules based on conventional ultrasound (US) and CEUS. This study aimed to evaluate the diagnostic efficacy of CEUS TI-RADS for benign and malignant thyroid nodules and to assess the related interobserver agreement.MethodsThe study recruited 433 patients who underwent thyroid US and CEUS between January 2019 and June 2023 at the Affiliated Hospital of Guangdong Medical University. A retrospective analysis of 467 thyroid nodules confirmed by fine-needle aspiration (FNA) and/or surgery was performed. Further, a CEUS TI-RADS classification was assigned to each thyroid nodule based on the CEUS TI-RADS scoring criteria for the US and CEUS features of the nodule. The nodules were grouped based on their sizes as follows: size ≤1 cm, group A; size >1 and ≤4 cm, group B; and size >4 cm, group C. Multivariate logistic regression was used to analyze independent risk factors for malignant thyroid nodules. Pathological assessment was the reference standard for establishing the sensitivity (SEN), specificity (SPE), accuracy (ACC), positive predictive value (PPV), and negative predictive value (NPV) of CEUS TI-RADS in diagnosing malignant thyroid nodules. The area under the curve (AUC) in the receiver operating characteristic (ROC) curve analysis was used to compare the diagnostic efficacy of the scoring system in predicting malignancy in three groups of nodules. The intragroup correlation coefficient (ICC) was adopted to assess the interobserver agreement of the CEUS TI-RADS score.ResultsOut of the 467 thyroid nodules, 262 were malignant and 205 were benign. Logistic regression analysis revealed that the independent risk factors for malignant thyroid nodules included punctate echogenic foci (P<0.001), taller-than-wide shape (P=0.015), extrathyroidal invasion (P=0.020), irregular margins/lobulation (P=0.036), hypoechoicity on US (P=0.038), and hypoenhancement on CEUS (P<0.001). The AUC for the CEUS TI-RADS in diagnosing malignant thyroid nodules was 0.898 for all nodules, 0.795 for group A, 0.949 for group B, and 0.801 for group C, with the optimal cutoff values of the CEUS TI-RADS being 5 points, 6 points, 5 points, and 5 points, respectively. Among these groups of nodules, group B had the highest AUC, with the SEN, SPE, ACC, PPV, and NPV for diagnosing malignant nodules being 95.9%, 88.1%, 92.8%, 92.6%, and 93.2%, respectively. The ICC of the CEUS TI-RADS classification between senior and junior physicians was 0.862 (P<0.001).ConclusionsIn summary, CEUS TI-RADS demonstrated significant efficacy in distinguishing thyroid nodules. Nonetheless, there were variations in its capacity to detect malignant nodules across diverse sizes, and it demonstrate optimal performance in 1- to 4-cm nodules. These findings may serve as important insights for clinical diagnoses.

Project description:BackgroundThyroid nodular disease is a common disorder. Ultrasonography has emerged as a powerful tool for the diagnosis of thyroid disease owing to its high operational simplicity, non-invasiveness and reproducibility. This study aimed to systematically evaluate the value of ultrasound elastography and conventional ultrasound for the diagnosis of thyroid nodules.MethodsThe PubMed, EMBASE, Cochrane Library, China National Knowledge Infrastructure, Wanfang and VIP databases were searched systematically. RevMan 5.3 software was used to draw a risk bias map, and Stata 16.0 was used to plot a sensitivity and specificity forest map. A summary receiver operating characteristics (SROC) curve was plotted, and the area under the curve (AUC) was calculated. Meta-regression was used to explore the sources of heterogeneity.ResultsThe sensitivity of conventional ultrasonography for detecting thyroid nodules was 0.55 [95% confidence interval (CI): 0.45-0.65], the specificity was 0.90 (95% CI: 0.87-0.93), the positive likelihood ratio was 5.8 (95% CI: 3.8-8.9), the negative likelihood ratio was 0.49 (95% CI: 0.39-0.6), and the AUC was 0.86 (95% CI: 0.82-0.88). The sensitivity of ultrasonic elastography for detecting thyroid nodules was 0.67 (95% CI: 0.60-0.73), the specificity was 0.93 (95% CI: 0.90-0.95), the positive likelihood ratio was 9.1 (95% CI: 6.3-13.3), the negative likelihood ratio was 0.36 (95% CI: 0.29-0.44), and the AUC was 0.89 (95% CI: 0.86-0.91). The sensitivity of conventional ultrasound combined with ultrasonic elastography for detecting thyroid nodules was 0.88 (95% CI: 0.84-0.90), the specificity of the combined approach was 0.96 (95% CI: 0.93-0.98), the positive likelihood ratio was 23.3 (95% CI: 12.4-43.6), the negative likelihood ratio was 0.13 (95% CI: 0.10-0.17), and the AUC was 0.92 (95% CI: 0.90-0.94). Age, region, research type, conventional ultrasound evaluation criteria and elastography evaluation criteria had specific effects on sensitivity and specificity when detecting thyroid nodules.ConclusionsConventional ultrasound can be used as a routine examination technique for the differential diagnosis of benign and malignant thyroid nodules, while ultrasound elastography can improve the sensitivity and specificity of the diagnosis. The diagnostic value of conventional ultrasound combined with ultrasound elastography is higher than that of a single diagnostic method.

Project description:Background: We performed a network meta-analysis to compare the diagnostic accuracy of contrast-enhanced ultrasound (CEUS) and shear wave elastography (SWE) in differentiating benign and malignant lesions in different body sites. Methods: A computerized literature search of Medline, Embase, SCOPUS, and Web of Science was performed using relevant keywords. Following data extraction, we calculated sensitivity, specificity, positive likelihood ratio (LR), negative LR, and diagnostic odds ratio (DOR) for CEUS, and SWE compared to histopathology as a reference standard. Statistical analyses were conducted by MetaDiSc (version 1.4) and R software (version 3.4.3). Results: One hundred and fourteen studies (15,926 patients) were pooled in the final analyses. Network meta-analysis showed that CEUS had significantly higher DOR than SWE (DOR = 27.14, 95%CI [2.30, 51.97]) in breast cancer detection. However, there were no significant differences between CEUS and SWE in hepatic (DOR = -6.67, 95%CI [-15.08, 1.74]) and thyroid cancer detection (DOR = 3.79, 95%CI [-3.10, 10.68]). Interestingly, ranking analysis showed that CEUS achieved higher DOR in detecting breast and thyroid cancer, while SWE achieved higher DOR in detecting hepatic cancer. The overall DOR for CEUS in detecting renal cancer was 53.44, 95%CI [29.89, 95.56] with an AUROC of 0.95, while the overall DOR for SWE in detecting prostate cancer was 25.35, 95%CI [7.15, 89.89] with an AUROC of 0.89. Conclusion: Both diagnostic tests showed relatively high sensitivity and specificity in detecting malignant tumors in different organs. Network meta-analysis showed that CEUS had higher diagnostic accuracy than SWE in detecting breast and thyroid cancer, while SWE had higher accuracy in detecting hepatic cancer. However, the results were not statistically significant in hepatic and thyroid malignancies. Further head-to-head comparisons are needed to confirm the optimal imaging technique to differentiate each cancer type.

Dataset Information

Ultrasound Real-Time Tissue Elastography Improves the Diagnostic Performance of the ACR Thyroid Imaging Reporting and Data System in Differentiating Malignant from Benign Thyroid Nodules: A Summary of 1525 Thyroid Nodules.

Publications

Ultrasound Real-Time Tissue Elastography Improves the Diagnostic Performance of the ACR Thyroid Imaging Reporting and Data System in Differentiating Malignant from Benign Thyroid Nodules: A Summary of 1525 Thyroid Nodules.

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