Preoperative differentiation of thyroid adenomas and thyroid carcinomas using high resolution contrast-enhanced ultrasound (CEUS)
To evaluate the impact of high-resolution contrast-enhanced ultrasound (CEUS) in combination with Color Coded and Power Doppler Sonography (CCDS/PD) in the preoperative differentiation of thyroid adenomas and thyroid carcinomas. A total of 101 patients (55 female, median age 54 years) underwent surg...
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Published in | Clinical hemorheology and microcirculation Vol. 61; no. 1; pp. 13 - 22 |
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Main Authors | , , , , , , , , |
Format | Journal Article |
Language | English |
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01.01.2015
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Abstract | To evaluate the impact of high-resolution contrast-enhanced ultrasound (CEUS) in combination with Color Coded and Power Doppler Sonography (CCDS/PD) in the preoperative differentiation of thyroid adenomas and thyroid carcinomas.
A total of 101 patients (55 female, median age 54 years) underwent surgery for thyroid adenoma and thyroid carcinoma. CCDS/PD and CEUS were performed in all patients by an experienced examiner using a multifrequency linear transducer (6-9 or 6-15 MHz) and were digitally stored. Reading of the ultrasound images was performed by two experienced radiologists in consensus. A histopathological evaluation was obtained as standard of reference in all patients.
Altogether, 75 thyroid adenomas and 26 thyroid carcinomas were detected. Mean diameter of thyroid adenomas and thyroid carcinomas was 27 mm and 32 mm, respectively. The differences in microcirculation of thyroid adenomas and thyroid carcinomas were statistically highly significant (p < 0.01). Representative features for thyroid adenomas were either no wash-out or wash-out with persisting edge in late phase, for thyroid carcinomas a complete wash-out in late phase. Thus, a calculation of sensitivity, specificity, positive and negative predictive value of 81% , 92% , 97% and 63%, respectively, for the differentiation of benignity and malignancy was possible.
Dynamic evaluation of microcirculation using CEUS and CCDS/PD enables a more reliable preoperative discrimination between thyroid adenomas and thyroid carcinomas. |
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AbstractList | BACKGROUNDTo evaluate the impact of high-resolution contrast-enhanced ultrasound (CEUS) in combination with Color Coded and Power Doppler Sonography (CCDS/PD) in the preoperative differentiation of thyroid adenomas and thyroid carcinomas.METHODSA total of 101 patients (55 female, median age 54 years) underwent surgery for thyroid adenoma and thyroid carcinoma. CCDS/PD and CEUS were performed in all patients by an experienced examiner using a multifrequency linear transducer (6-9 or 6-15 MHz) and were digitally stored. Reading of the ultrasound images was performed by two experienced radiologists in consensus. A histopathological evaluation was obtained as standard of reference in all patients.RESULTSAltogether, 75 thyroid adenomas and 26 thyroid carcinomas were detected. Mean diameter of thyroid adenomas and thyroid carcinomas was 27 mm and 32 mm, respectively. The differences in microcirculation of thyroid adenomas and thyroid carcinomas were statistically highly significant (p < 0.01). Representative features for thyroid adenomas were either no wash-out or wash-out with persisting edge in late phase, for thyroid carcinomas a complete wash-out in late phase. Thus, a calculation of sensitivity, specificity, positive and negative predictive value of 81% , 92% , 97% and 63%, respectively, for the differentiation of benignity and malignancy was possible.CONCLUSIONSDynamic evaluation of microcirculation using CEUS and CCDS/PD enables a more reliable preoperative discrimination between thyroid adenomas and thyroid carcinomas. To evaluate the impact of high-resolution contrast-enhanced ultrasound (CEUS) in combination with Color Coded and Power Doppler Sonography (CCDS/PD) in the preoperative differentiation of thyroid adenomas and thyroid carcinomas. A total of 101 patients (55 female, median age 54 years) underwent surgery for thyroid adenoma and thyroid carcinoma. CCDS/PD and CEUS were performed in all patients by an experienced examiner using a multifrequency linear transducer (6-9 or 6-15 MHz) and were digitally stored. Reading of the ultrasound images was performed by two experienced radiologists in consensus. A histopathological evaluation was obtained as standard of reference in all patients. Altogether, 75 thyroid adenomas and 26 thyroid carcinomas were detected. Mean diameter of thyroid adenomas and thyroid carcinomas was 27 mm and 32 mm, respectively. The differences in microcirculation of thyroid adenomas and thyroid carcinomas were statistically highly significant (p < 0.01). Representative features for thyroid adenomas were either no wash-out or wash-out with persisting edge in late phase, for thyroid carcinomas a complete wash-out in late phase. Thus, a calculation of sensitivity, specificity, positive and negative predictive value of 81% , 92% , 97% and 63%, respectively, for the differentiation of benignity and malignancy was possible. Dynamic evaluation of microcirculation using CEUS and CCDS/PD enables a more reliable preoperative discrimination between thyroid adenomas and thyroid carcinomas. |
Author | Agha, A Janke, M Schlitt, H J Schacherer, D Hornung, M Jung, E M Schleder, S Stroszczynski, C Schreyer, A G |
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References_xml | – volume: 19 start-page: 1167 year: 2009 ident: 10.3233/CH-141848_ref4 article-title: Revised American Thyroid Association management guidelines for patients with thyroid nodules and differentiated thyroid cancer publication-title: Thyroid doi: 10.1089/thy.2009.0110 contributor: fullname: Cooper – volume: 28 start-page: 502 year: 2007 ident: 10.3233/CH-141848_ref11 article-title: Vascularisation of benign and malignant thyroid nodules: CD US evaluation publication-title: Ultraschall Med doi: 10.1055/s-2007-963023 contributor: fullname: Ivanac – volume: 16 start-page: 109 year: 2006 ident: 10.3233/CH-141848_ref3 article-title: Management guidelines for patients with thyroid nodules and differentiated thyroid cancer publication-title: Thyroid doi: 10.1089/thy.2006.16.109 contributor: fullname: Cooper – volume: 50 start-page: 79 year: 2012 ident: 10.3233/CH-141848_ref9 article-title: Multimodality imaging using ultrasound image fusion in renal lesions publication-title: Clin Hemorheol Microcirc doi: 10.3233/CH-2011-1445 contributor: fullname: Helck – volume: 52 start-page: 197 year: 2012 ident: 10.3233/CH-141848_ref10 article-title: Detection of microvascularization of thyroid carcinomas using linear high resolution contrast-enhanced ultrasonography (CEUS) publication-title: Clin Hemorheol Microcirc doi: 10.3233/CH-2012-1597 contributor: fullname: Hornung – volume: 20 start-page: 51 year: 2010 ident: 10.3233/CH-141848_ref18 article-title: Utility of contrast-enhanced ultrasound for evaluation of thyroid nodules publication-title: Thyroid doi: 10.1089/thy.2009.0045 contributor: fullname: Zhang – volume: 97 start-page: 4524 year: 2012 ident: 10.3233/CH-141848_ref17 article-title: Ultrasound sensitivity for thyroid malignancy is increased by real-time elastography: A prospective multicenter study publication-title: J Clin Endocrinol Metab doi: 10.1210/jc.2012-2951 contributor: fullname: Trimboli – volume: 33 start-page: S39 issue: Suppl 1 year: 2012 ident: 10.3233/CH-141848_ref5 article-title: EFSUMB guidelines: Comment on emergent indications and visions publication-title: Ultraschall Med contributor: fullname: Dietrich – volume: 118 start-page: 602 year: 2010 ident: 10.3233/CH-141848_ref7 article-title: Real-time elastography and contrast-enhanced ultrasound for the assessment of thyroid nodules publication-title: Exp Clin Endocrinol Diabetes doi: 10.1055/s-0029-1237701 contributor: fullname: Friedrich-Rust – volume: 32 start-page: 593 year: 2011 ident: 10.3233/CH-141848_ref15 article-title: Diagnostic accuracy of CEUS in the differential diagnosis of small (< /=20mm) and subcentimetric (< /=10mm) focal liver lesions in comparison with histology. 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Snippet | To evaluate the impact of high-resolution contrast-enhanced ultrasound (CEUS) in combination with Color Coded and Power Doppler Sonography (CCDS/PD) in the... BACKGROUNDTo evaluate the impact of high-resolution contrast-enhanced ultrasound (CEUS) in combination with Color Coded and Power Doppler Sonography (CCDS/PD)... |
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SubjectTerms | Contrast Media - therapeutic use Female Humans Male Middle Aged Preoperative Period Thyroid Neoplasms - diagnosis Thyroid Neoplasms - surgery Ultrasonography, Doppler, Color - methods |
Title | Preoperative differentiation of thyroid adenomas and thyroid carcinomas using high resolution contrast-enhanced ultrasound (CEUS) |
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