Aims and objectives
Thyroid nodules are a common finding in the general population,
and their detection rate is increasing with the widespread use of ultrasound (US).
Most thyroid nodules are benign,
and fewer than 5% are malignant [1]
Conventional thyroid US has been widely used to stratify the malignant risk of thyroid nodules.
Microcalcifications,
irregular margins,
and tall shape are the features with high specificities for thyroid cancer,
but none of them are independently and fully predictive of malignancy [2] (an example of suspicious nodule characteristic is shown...
Methods and materials
B-mode US images and CEUS exams of 40 patients with single predominantly solid thyroid nodule were retrospectively analysed to define both the TI-RADS class and TIC.
CEUS exam
The general process of CEUS for thyroid nodules was as follows:
the largest view of the nodule was chosen before switching to the CEUS mode from B-mode US;
SonoVue (Bracco,
Italy) was injected intravenously as a bolus at a standardize dose of 2.4 mL,
followed by a 8 mL saline flush;
the CEUS images were recorded as...
Results
Seven nodules were classified as TI-RADS 5 and 9,
9,
7 and 8 nodules as TI-RADS 4b,
4a,
3 and 2,
respectively.
TI-RADS classification was statistically related to nodule histology (p=0.005).
All nodules classified as TI-RAD 4b and 5 were malignant (Fig.5).
In 9 nodules out of 19,
which were classified as TI-RADS 2,
3 and 4a,
the histology was malignant.In this “low-risk group”,
the TIC analysis allowed identifying malignant lesions.
In fact,
AUCF in the benign nodules was 476.1±304.9*103,
whereas in the malignant ones...
Conclusion
TheTI-RADS classification and TIC analysis of CEUS areboth promising and valuable tools for differentiating benign and malignant thyroid nodules.
Personal information
Antonio Boccuzzi,
Salvatore Mazzeo,
Rosa Cervelli,
Piercarlo Rossi and Davide Caramella work at the University of PisaDiagnostic and Interventional Radiology.
Roberto Cioni works at the U.O.
Radiologia Interventisticaof the University Hospital of Pisa.
Piermarco Papini,
Gabriele Materazzi work a the U.O.
Endocrinochirurgiaof the Univerity Hospital of Pisa.
References
Remonti LR,
Kramer CK,
Leitao CB,
et al.
Thyroid ultrasound features and risk of carcinoma: a systematic review and meta-analysis of observational studies.
Thyroid 2015;25:538-550;
Haugen BR,
Alexander EK,
Bible KC,
et al.
American thyroid association management guidelines for adult patients with thyroid nodules and differentiated thyroid cancer: the American Thyroid Association guidelines task force on thyroid nodules and differentiated thyroid cancer,
Thyroid 26 (2016) (2015) 1–133;
Horvath E,
Majlis S,
Rossi R,
Franco C,
Niedmann JP,
Castro A et al (2009) An ultrasonogram reporting...