Medical Image Analysis of Ultrasonographic Calcifications in Differentiating Benign and Malignant Thyroid Nodules

Aim: Our paper aims to analyze ultrasonographic (US) calcifications in differentiating benign and malignant thyroid nodules. Methods: We retrospectively analyzed 1,121 recruited calcified thyroid nodules underwent US scanning for this study. All these nodules were pathologically confirmed after surgery. Then, observation was performed for the subsequent analysis of the proportions of each kind of microcalcifications in both benign and malignant nodules. These can include coarse or macrocalcifications, rim and mixed calcifications and the incidences of benignity and malignancy of different types of calcified nodules. Results: There were 1,121 thyroid lesions recruited in this study and most of them were malignant, taking up 97.94% (1098/1,121), among which papillary carcinoma took up 99.73% (1095/1098). And the rest of 23 nodules were diagnosed as benign, in which the nodular goiters were the most frequently diagnosed with the incidence of 97.67% (42/43). Conclusion: Multiple microcalcifications are generally considered as an US appearance of thyroid cancers. More attention is needed when nodules with the uneven edges, fragment macrocalcifications or peripheral hypoechoic halo and these US findings may lead to a diagnosis of malignancy. Mixed-calcified nodules have a tendency to malignancy. Stratified nodules may tend to be benign if we see there are features like rim calcifications, dilated vessels but low RI value and further evaluation of this kind of lesions is warranted.