The role of multimodal ultrasonic flow imaging in Thyroid Imaging Reporting and Data System (TI-RADS) 4 nodules

被引:29
作者
Zhang, Libo [1 ]
Gu, Junyi [1 ]
Zhao, Yuxin [1 ]
Zhu, Min [1 ]
Wei, Jing [1 ]
Zhang, Bo [1 ]
机构
[1] Dongfang Hosp, Dept Ultrasound, 150 Jimo Rd, Shanghai 200120, Peoples R China
关键词
Ultrasound; thyroid nodule; Thyroid Imaging Reporting and Data System (TI-RADS); superb microvascular imaging (SMI); contrast-enhanced ultrasound (CEUS); CONTRAST-ENHANCED ULTRASOUND; ULTRASONOGRAPHY; MALIGNANCY; FEATURES; BENIGN; RISK; STEP;
D O I
10.21037/gs-20-641
中图分类号
R61 [外科手术学];
学科分类号
摘要
Background: Color Doppler imaging (CDFI), contrast-enhanced ultrasound (CEUS), and superb microvascular imaging (SMI) are used to observe blood flow characteristics in Thyroid Imaging Reporting and Data System (TI-RADS) 4 nodules. The ability of these techniques to distinguish benign from malignant nodules was investigated. Methods: A total of 75 TI-RADS 4 nodules were examined using CDFI, SMI, and CEUS. The blood flow characteristics shown by the three methods were added to the current TI-RADS classification to establish a new TI-RADS classification. The value of the three methods and the diagnostic accuracy of the new and old TI-RADS classification were compared. Results: SMI better captured type II flow in benign nodules and type III flow in malignant nodules relative to CDFI. Malignant nodules detected with CEUS manifested mainly with hypo-enhancement, whereas benign nodules showed iso- and hyper-enhancement. The areas under the receiver operating characteristic (ROC) curves (AUC) obtained through the aforementioned flow distribution models were 0.690 (CDFI), 0.840 (SMI), 0.910 (CEUS), and 0.903 (CEUS and SMI combined mode), respectively. The diagnostic value of CEUS was the highest. Joint inspection using SMI with CEUS showed certain advantages in sensitivity, although the overall accuracy was equal to that of CEUS alone. Except for CDFI, the AUC of the new TI-RADS classification was significantly higher than that of the old one. Perforating vessels and low enhancement were independent predictors of thyroid carcinoma. Conclusions: Both SMI and CEUS visualized lower-velocity blood flow within TI-RADS 4 nodules. The new TI-RADS classification described here could improve diagnostic accuracy.
引用
收藏
页码:1469 / 1477
页数:9
相关论文
共 50 条
[21]   Reducing the Number of Unnecessary Thyroid Nodule Biopsies With the American College of Radiology (ACR) Thyroid Imaging Reporting and Data System (TI-RADS) [J].
Abou Shaar, Bader ;
Meteb, Moussa ;
El-Karim, Ghassan Awad ;
Almalki, Youssef .
CUREUS JOURNAL OF MEDICAL SCIENCE, 2022, 14 (03)
[22]   Virtual Touch Tissue Imaging and Quantification (VTIQ) combined with the American College of Radiology Thyroid Imaging Reporting and Data System (ACR TI-RADS) for malignancy risk stratification of thyroid nodules [J].
Li, Xiang ;
Hou, Xiu-Juan ;
Du, Lin-Yao ;
Wu, Jia-Qi ;
Wang, Luo ;
Wang, Hong ;
Zhou, Xian-Li .
CLINICAL HEMORHEOLOGY AND MICROCIRCULATION, 2019, 72 (03) :279-291
[23]   Diagnostic value of multimodal ultrasound imaging in differentiating benign and malignant TI-RADS category 4 nodules [J].
Pei, Shufang ;
Cong, Shuzhen ;
Zhang, Bin ;
Liang, Changhong ;
Zhang, Lu ;
Liu, Juanjuan ;
Guo, Yuping ;
Zhang, Shuixing .
INTERNATIONAL JOURNAL OF CLINICAL ONCOLOGY, 2019, 24 (06) :632-639
[24]   Comparison of Incidental Thyroid Nodules Between Early Breast Cancer Patients and Healthy Controls: Higher Incidence and Thyroid Imaging Reporting and Data System (TI-RADS) Score of Patients with Cancer [J].
Raoufi, Masoomeh ;
Anbiaee, Robab ;
Soltani, Zohre ;
Shojaeian, Fatemeh ;
Safavi-Naini, Seyed Amir Ahmad .
INTERNATIONAL JOURNAL OF CANCER MANAGEMENT, 2021, 14 (09)
[25]   Likelihood of malignancy in thyroid nodules according to a proposed Thyroid Imaging Reporting and Data System (TI-RADS) classification merging suspicious and benign ultrasound features [J].
Costantin Delfim, Ricardo Luiz ;
Garcez da Veiga, Leticia Carrasco ;
Aguiar Vidal, Ana Paula ;
Proenca Lobo Lopes, Flavia Paiva ;
Vaisman, Mario ;
dos Santos Teixeira, Patricia de Fatima .
ARCHIVES OF ENDOCRINOLOGY METABOLISM, 2017, 61 (03) :211-221
[26]   Diagnostic accuracy and ability to reduce unnecessary FNAC: A comparison between four Thyroid Imaging Reporting Data System (TI-RADS) versions [J].
Tan, Lingsze ;
Tan, Ying Sern ;
Tan, Suzet .
CLINICAL IMAGING, 2020, 65 (65) :133-137
[27]   Multivariate evaluation of Thyroid Imaging Reporting and Data System (TI-RADS) in diagnosis malignant thyroid nodule: application to PCA and PLS-DA analysis [J].
Zhang, Tan ;
Li, Fangxuan ;
Mu, Jiali ;
Liu, Juntian ;
Zhang, Sheng .
INTERNATIONAL JOURNAL OF CLINICAL ONCOLOGY, 2017, 22 (03) :448-454
[28]   A single-center multidisciplinary study analyzing thyroid nodule risk stratification by comparing the thyroid imaging reporting and data system (TI-RADS) and American thyroid association (ATA) risk of malignancy for thyroid nodules [J].
Asya, Orhan ;
Yumusakhuylu, Ali Cemal ;
Enver, Necati ;
Gundogdu, Yavuz ;
Abuzaid, Ghazi ;
Incaz, Sefa ;
Gundogmus, Cemal Aydin ;
Ergelen, Rabia ;
Bagci, Pelin ;
Oysu, Cagatay .
AURIS NASUS LARYNX, 2023, 50 (03) :410-414
[29]   The Diagnostic Role of Computed Tomography for ACR TI-RADS 4-5 Thyroid Nodules With Coarse Calcifications [J].
Wei, Peiying ;
Jiang, Niandong ;
Ding, Jinwang ;
Xiang, JingJing ;
Wang, Luoyu ;
Wang, Haibin ;
Gu, Ying ;
Luo, DingCun ;
Han, Zhijiang .
FRONTIERS IN ONCOLOGY, 2020, 10
[30]   Modification of size cutoff for biopsy based on the American College of Radiology Thyroid Imaging Reporting and Data System (TI-RADS) for thyroid nodules in patients younger than 19 years [J].
Huang, Yunxia ;
Liu, Jieyu ;
Zheng, Taiqing ;
Zhong, Jia ;
Tan, Yan ;
Liu, Minghui ;
Wang, Guotao .
EUROPEAN RADIOLOGY, 2023, 33 (12) :9328-9335