Artificial Intelligence for Breast Cancer Screening in Mammography (AI-STREAM): A Prospective Multicenter Study Design in Korea Using AI-Based CADe/x / 한국유방암학회지

Purpose@#Artificial intelligence (AI)-based computer-aided detection/diagnosis (CADe/x) has helped improve radiologists’ performance and provides results equivalent or superior to those of radiologists’ alone. This prospective multicenter cohort study aims to generate real-world evidence on the overall benefits and disadvantages of using AI-based CADe/x for breast cancer detection in a population-based breast cancer screening program comprising Korean women aged ≥ 40 years. The purpose of this report is to compare the diagnostic accuracy of radiologists with and without the use of AI-based CADe/x in mammography readings for breast cancer screening of Korean women with average breast cancer risk. @*Methods@#Approximately 32,714 participants will be enrolled between February 2021 and December 2022 at 5 study sites in Korea. A radiologist specializing in breast imaging will interpret the mammography readings with or without the use of AI-based CADe/x. If recall is required, further diagnostic workup will be conducted to confirm the cancer detected on screening. The findings will be recorded for all participants regardless of their screening status to identify study participants with breast cancer diagnosis within both 1 year and 2 years of screening. The national cancer registry database will be reviewed in 2026 and 2027, and the results of this study are expected to be published in 2027. In addition, the diagnostic accuracy of general radiologists and radiologists specializing in breast imaging from another hospital with or without the use of AI-based CADe/x will be compared considering mammography readings for breast cancer screening.DiscussionThe Artificial Intelligence for Breast Cancer Screening in Mammography (AI-STREAM) study is a prospective multicenter study that aims to compare the diagnostic accuracy of radiologists with and without the use of AI-based CADe/x in mammography readings for breast cancer screening of women with average breast cancer risk. AI-STREAM is currently in the patient enrollment phase.Trial RegistrationClinicalTrials.gov Identifier: NCT05024591

Reproducibility and diagnostic performance of the vascular index of superb microvascular imaging in real-time breast ultrasonography for evaluating breast masses

Purpose@#This study aimed to evaluate the reproducibility and diagnostic performance of a quantitative parameter of superb microvascular imaging (SMI) in real-time breast ultrasonography (US) for differentiating benign from malignant breast masses. @*Methods@#Eighty-seven breast masses in 75 patients who underwent both B-mode US and SMI before US-guided core needle biopsy were included in this study. Two radiologists performed B-mode US and measured the vascular index (VI) of SMI respectively for each lesion in real time. Intraobserver and interobserver agreements were analyzed for the VI of SMI. The diagnostic performance of B-mode US using the Breast Imaging Reporting and Database System lexicon and combined use with the VI of SMI was evaluated compared to pathology. @*Results@#The median VI of malignant masses (n=32) was significantly higher than that of benign masses (n=55) (7.6% and 2.6%, respectively; P<0.001). The intraobserver agreement for VI was excellent regardless of the pathology, size, or depth of the lesion. The interobserver agreement for VI was excellent regardless of the presence of a measurement interval. The interobserver agreement for the final diagnostic decision was improved by combining B-mode US and VI (κ=0.883) in comparison with B-mode US only (κ=0.617). Adding VI led to significant improvements in the specificity (87.2% vs. 52.7%, 83.6% vs. 49.0%), accuracy (89.7% vs. 69.3%, 84.0% vs. 65.9%) and positive predictive value (81.5% vs. 55.1%, 75.6% vs. 52.6%) of B-mode US for both observers compared with B-mode US alone (all, P=0.001). @*Conclusion@#The VI of SMI for real-time breast US is highly reproducible and leads to improved diagnostic performance for differentiating between benign and malignant breast lesions in combination with B-mode US.

Disseminated Peritoneal Leiomyomatosis with Atypical Features and Comorbid Uterine STUMP: a Case Report and Review of the Literature

Disseminated peritoneal leiomyomatosis (DPL) is a very rare benign disease, characterized by multiple solid subperitoneal or peritoneal smooth muscle nodules in abdominopelvic cavity and malignant transformation is extremely rare. Also, uterine smooth muscle tumors of unknown malignant potential (STUMP) is a rare tumor, which is regarded as subclassification in uterine smooth muscle tumors between benign and malignant criteria. Pathogenesis of DPL is uncertain, but increasing evidence of iatrogenic cause including laparoscopic myomectomy has been reported.We report a case of a 28-year-old female with previous history of laparoscopic myomectomy diagnosed with DPL with atypical feature and concurrent uterine STUMP using computed tomography (CT) and magnetic resonance imaging (MRI), as well as present a review of the literature.

Combination of Quantitative Parameters of Shear WaveElastography and Superb Microvascular Imaging toEvaluate Breast Masses

Objective@#This study aimed to evaluate the diagnostic value of combining the quantitative parameters of shear waveelastography (SWE) and superb microvascular imaging (SMI) to breast ultrasound (US) to differentiate between benign andmalignant breast masses. @*Materials and Methods@#A total of 200 pathologically confirmed breast lesions in 192 patients were retrospectively reviewedusing breast US with B-mode imaging, SWE, and SMI. Breast masses were assessed based on the breast imaging reporting anddata system (BI-RADS) and quantitative parameters using the maximum elasticity (Emax) and ratio (Eratio) in SWE and thevascular index in SMI (SMIVI). The area under the receiver operating characteristic curve (AUC) value, sensitivity, specificity,accuracy, negative predictive value, and positive predictive value of B-mode alone versus the combination of B-mode US withSWE or SMI of both parameters in differentiating between benign and malignant breast masses was compared, respectively.Hypothetical performances of selective downgrading of BI-RADS category 4a (set 1) and both upgrading of category 3 anddowngrading of category 4a (set 2) were calculated. @*Results@#Emax with a cutoff value of 86.45 kPa had the highest AUC value compared to Eratio of 3.57 or SMIVI of 3.35%. Inset 1, the combination of B-mode with Emax or SMIVI had a significantly higher AUC value (0.829 and 0.778, respectively)than B-mode alone (0.719) (p< 0.001 and p= 0.047, respectively). B-mode US with the addition of Emax, Eratio, and SMIVIhad the best diagnostic performance of AUC value (0.849). The accuracy and specificity increased significantly from 68.0%to 84.0% (p< 0.001) and from 46.1% to 79.1% (p< 0.001), respectively, and the sensitivity decreased from 97.6% to 90.6%without statistical loss (p= 0.199). @*Conclusion@#Combining all quantitative values of SWE and SMI with B-mode US improved the diagnostic performance indifferentiating between benign and malignant breast lesions.

Long-Term Follow-Up Ultrasonographic Findings of Intrathyroidal Thymus in Children

Objective@#To analyze long-term follow-up sonographic findings of intrathyroidal thymus in children. @*Materials and Methods@#Among 1259 patients with congenital hypothyroidism under 15 years of age who underwent thyroid ultrasonography (US), 41 patients were diagnosed with an intrathyroidal thymus based on US criteria, i.e., hypoechoic solid lesion with punctate and linear echogenicity. In 26 patients aged one to 14 years old, the last follow-up US was performed after 6 to 132 months and compared with the initial US. The lesion was considered to decrease in size if there was a change of more than 2 mm in any dimension. The margin change was divided into well-defined and indistinct, blurred. When the echogenicity changed to a hyperechoic from a characteristic thymic echogenicity pattern, the pattern was considered a hyperechogenic. The changes in size were compared with the changes in shape, margin, and echogenicity pattern. The changes in size, shape, margin, and echogenicity were analyzed the association with the age of last follow-up. Statistical analysis was conducted using the chi-squared test and logistic regression. @*Results@#Fifteen (57.7%) cases were stable in size, and 11 (42.3%) decreased in size, including one that disappeared. Ten (38.5%) cases changed to indistinct margins from initially well-defined margins including one case of initially indistinct margin. Six (23.1%) changed to hyperechogenic, from initially characteristic thymic echogenicity patterns. When follow-up change was compared, decreases in size were significantly associated with lesion changes to indistinct margins (p = 0.004).The age at last follow-up was significantly associated with change to hyperechogenicity (odd ratio, 2.141; 95% confidence interval, 1.144–4.010, p = 0.017). @*Conclusion@#On follow-up US, an intrathyroidal thymus may be decreased in size, with indistinct margins, or show changes to a hyperechoic mass. Decreases in size may be associated with changing to indistinct margins, and changes to hyperechogenicity may be associated with increasing age.

Mesenteric Lesions with Similar or Distinctive Appearances on CT

The mesentery is a structure comprising a double peritoneal layer that attaches the bowel to the abdominal wall. Mesenteric disease can cause various non-specific clinical symptoms in adults and is sometimes found incidentally during unrelated diagnostic imaging studies. CT plays an essential role in the diagnosis of mesenteric disease, which can present with various radiologic features, including a solid mass, cystic mass, or local or diffuse infiltration on CT. Some mesenteric diseases present with distinctive characteristics, while others share similar findings, thereby complicating their differential diagnosis. Therefore, understanding the radiological findings of mesenteric disease is important for accurate diagnosis and appropriate treatment.

Imaging Findings of Breast Metastasis from Squamous Cell Carcinoma of the Cervix: A Case Report

Metastasis from extramammary malignancy to the breast is rare, and metastasis of cervical cancer to the breast is quite uncommon. We report atypical sonographic findings of a rapid growing, single, and circumscribed mass with complex cystic and solid echo pattern in a 50-year-old female. The mass confirmed a metastasis from cervical cancer. It is rare, but the possibility of breast metastasis should be considered when a rapidly growing breast mass is located in between the parenchyma and subcutaneous fat layer.

Interobserver agreement in breast ultrasound categorization in the Mammography and Ultrasonography Study for Breast Cancer Screening Effectiveness (MUST-BE) trial: results of a preliminary study

PURPOSE: The purpose of this study was to record and evaluate interobserver agreement as quality control for the modified categorization of screening breast ultrasound developed by the Alliance for Breast Cancer Screening in Korea (ABCS-K) for the Mammography and Ultrasonography Study for Breast Cancer Screening Effectiveness (MUST-BE) trial. METHODS: Eight breast radiologists with 4-16 years of experience participated in 2 rounds of quality control testing for the MUST-BE trial. Two investigators randomly selected 125 and 100 cases of breast lesions with different ratios of malignant and benign lesions. Two versions of the modified categorization were tested. The initially modified classification was developed after the first quality control workshop, and the re-modified classification was developed after the second workshop. The re-modified categorization established by ABCS-K added size criteria and the anterior-posterior ratio compared with the initially modified classification. After a brief lecture on the modified categorization system prior to each quality control test, the eight radiologists independently categorized the lesions using the modified categorization. Interobserver agreement was measured using kappa statistics. RESULTS: The overall kappa values for the modified categorizations indicated moderate to substantial degrees of agreement (initially modified categorization and re-modified categorization: κ=0.52 and κ=0.63, respectively). The kappa values for the subcategories of category 4 were 0.37 (95% confidence interval [CI], 0.24 to 0.52) and 0.39 (95% CI, 0.31 to 0.49), respectively. The overall kappa values for both the initially modified categorization and the re-modified categorization indicated a substantial degree of agreement when dichotomizing the interpretation as benign or suspicious. CONCLUSION: The preliminary results demonstrated acceptable interobserver agreement for the modified categorization.

Primary Pelvic Peritoneal Yolk Sac Tumor in the Post-Pubertal Female: a Case Report with Literature Review

Yolk sac tumors are rare malignant germ cell neoplasms that usually arise from the gonads. Extragonadal yolk sac tumors (EGYSTs) frequently occur in the mediastinum in post-pubertal females. EGYSTs in the pelvis are extremely rare, and to date, only thirteen cases have been reported in the English literature. Among them, the primary EGYST of the pelvic peritoneum in post-pubertal females has only been reported in ten cases. The present case describes a 26-year-old female diagnosed with primary peritoneal yolk sac tumor located in the rectouterine pouch. We report clinical and tumor imaging features, including ultrasound, computed tomography (CT), magnetic resonance images (MRI), positron emission tomography-computed tomography (PET-CT), and present a review of the literature.

Interpretive Performance and Inter-Observer Agreement on Digital Mammography Test Sets

OBJECTIVE: To evaluate the interpretive performance and inter-observer agreement on digital mammographs among radiologists and to investigate whether radiologist characteristics affect performance and agreement. MATERIALS AND METHODS: The test sets consisted of full-field digital mammograms and contained 12 cancer cases among 1000 total cases. Twelve radiologists independently interpreted all mammograms. Performance indicators included the recall rate, cancer detection rate (CDR), positive predictive value (PPV), sensitivity, specificity, false positive rate (FPR), and area under the receiver operating characteristic curve (AUC). Inter-radiologist agreement was measured. The reporting radiologist characteristics included number of years of experience interpreting mammography, fellowship training in breast imaging, and annual volume of mammography interpretation. RESULTS: The mean and range of interpretive performance were as follows: recall rate, 7.5% (3.3–10.2%); CDR, 10.6 (8.0–12.0 per 1000 examinations); PPV, 15.9% (8.8–33.3%); sensitivity, 88.2% (66.7–100%); specificity, 93.5% (90.6–97.8%); FPR, 6.5% (2.2–9.4%); and AUC, 0.93 (0.82–0.99). Radiologists who annually interpreted more than 3000 screening mammograms tended to exhibit higher CDRs and sensitivities than those who interpreted fewer than 3000 mammograms (p = 0.064). The inter-radiologist agreement showed a percent agreement of 77.2–88.8% and a kappa value of 0.27–0.34. Radiologist characteristics did not affect agreement. CONCLUSION: The interpretative performance of the radiologists fulfilled the mammography screening goal of the American College of Radiology, although there was inter-observer variability. Radiologists who interpreted more than 3000 screening mammograms annually tended to perform better than radiologists who did not.

Breast Lesions in Children and Adolescents: Diagnosis and Management

Pediatric breast disease is uncommon, and primary breast carcinoma in children is extremely rare. Therefore, the approach used to address breast lesions in pediatric patients differs from that in adults in many ways. Knowledge of the normal imaging features at various stages of development and the characteristics of breast disease in the pediatric population can help the radiologist to make confident diagnoses and manage patients appropriately. Most breast diseases in children are benign or associated with breast development, suggesting a need for conservative treatment. Interventional procedures might affect the developing breast and are only indicated in a limited number of cases. Histologic examination should be performed in pediatric patients, taking into account the size of the lesion and clinical history together with the imaging findings. A core needle biopsy is useful for accurate diagnosis and avoidance of irreparable damage in pediatric patients. Biopsy should be considered in the event of abnormal imaging findings, such as non-circumscribed margins, complex solid and cystic components, posterior acoustic shadowing, size above 3 cm, or an increase in mass size. A clinical history that includes a risk factor for malignancy, such as prior chest irradiation, known concurrent cancer not involving the breast, or family history of breast cancer, should prompt consideration of biopsy even if the lesion has a probably benign appearance on ultrasonography.

Ultrasonographic features of pure ductal carcinoma in situ of the breast: correlations with pathologic features and biological markers

PURPOSE: The purpose of this study was to evaluate the ultrasonographic features of pure ductal carcinoma in situ (DCIS) of the breast and to evaluate the correlations of ultrasonographic features with pathologic and biological features. METHODS: A total of 141 lesions in 138 women with pure DCIS who underwent preoperative breast ultrasonography were retrospectively reviewed. Ultrasonographic features were analyzed using the American College of Radiology Breast Imaging Reporting and Data System (BI-RADS) ultrasonography lexicon and the diagnostic criteria of the Japan Society of Ultrasonics in Medicine. Pathologic features including the nuclear grade and presence of comedonecrosis were evaluated. Biological markers including estrogen receptor, progesterone receptor, and human epidermal growth factor receptor 2 (HER2) status, as well as the Ki-67 index, were recorded. Ultrasonographic features were compared with pathologic findings and biological markers using the chi-square test. P-values of < 0.05 were considered to indicate statistical significance. RESULTS: Of the 141 lesions, 75 (53.2%) were mass lesions, 56 (39.7%) were non-mass lesions, and 10 (7.1%) were not visible. The most common feature of the mass pattern was a mass with irregular shape (32.6%), an indistinct margin (27.7%), and hypoechogenicity (37.6%). Microcalcifications were observed in 48 cases (36.6%) as an associated feature. Calcifications outside of a mass were more common than calcifications within a mass. Ultrasonographic microcalcifications and ductal changes were frequently observed in non-mass lesions. Ultrasonographic non-mass lesions were associated with high-grade DCIS (P=0.004) and the presence of comedonecrosis (P=0.006). Microcalcifications were significantly associated with high-grade DCIS (P < 0.001), the presence of comedonecrosis (P < 0.001), an elevated Ki-67 (P < 0.001), and HER2 positivity (P=0.003). CONCLUSION: The most common ultrasonographic feature of pure DCIS was an irregular, hypoechoic mass with an indistinct margin. Ultrasonographic microcalcifications and ductal changes were more frequent in non-mass lesions, which were correlated with poor prognostic factors, such as a high nuclear grade, comedonecrosis, HER2 positivity, and an elevated Ki-67 index.

Acute diverticulitis of the terminal ileum: ultrasonography and CT findings

We describe a rare case of terminal ileal diverticulitis in a 68-year-old female with a day of history of right lower quadrant pain and tenderness, mimicking acute appendicitis. Ultrasonography revealed small sac-like out-pouching lesions with increased echogenicity of surrounding fat in thickened terminal ileum, suggesting inflamed diverticula. We diagnosed terminal ileal diverticulitis primarily by ultrasonography. The diagnosis was confirmed by subsequent computed tomography.

The Difference in Diagnostic Performance for Detection of Supraspinatus Tendon Tears by Adding Angled Oblique Sagittal Plane Image to the Routine Shoulder MRI

PURPOSE: The purpose of this study is to determine whether adding an angled oblique sagittal plane to the routine shoulder MRI improves the diagnostic performance in the evaluation of supraspinatus tendon tears with arthroscopic correlation. MATERIALS AND METHODS: The study included 121 patients who had a shoulder MRI followed by arthroscopy. Two radiologists separately evaluated the supraspinatus tendon for tears on shoulder MRI either with or without the angled oblique sagittal images. Arthroscopy was used as the reference standard. The sensitivity and specificity for diagnosing supraspinatus tendon tears were calculated and compared by using McNemar test. Interobserver and intertechnique variability in the interpretation of supraspinatus tendon tears were calculated as a kappa value. RESULTS: Adding the angled oblique sagittal images to the standard shoulder MRI showed improvement in the sensitivity for diagnosing full-thickness supraspinatus tendon tears and also in the sensitivity, specificity and accuracy for the detection of partial-thickness tears. However, there was no statistically significant difference in all of them between with and without the angled set. Interobserver agreement was substantial to almost perfect and intertechnique agreement was moderate. CONCLUSION: Adding an angled oblique sagittal plane image to the routine shoulder MRI showed no significantly different diagnostic performance in detecting the partial- and full-thickness supraspinatus tendon tears, compared to MRI without angled oblique sagittal plane.

Characteristics of thyroid nodules in infant with congenital hypothyroidism / 소아과

PURPOSE: This study aimed to assess the characteristics of thyroid nodules among infants diagnosed with congenital hypothyroidism. METHODS: A retrospective study of 660 infants (374 males, 286 females) diagnosed with congenital hypothyroidism was carried out at the Pediatric Endocrine Clinic in Soonchunhyang University Hospital, Korea, between May 2003 and February 2013. The average age at diagnosis was 1.16+/-1.68 months. RESULTS: Of the 28 patients (4.2%) with thyroid nodules, 17 (2.6%) had cystic thyroid nodules and 11 (1.6%) had solid thyroid nodules. There were no significant differences in gender or age between congenital hypothyroidism patients who hadthyroid nodules and those who did not. All nodules were asymptomatic. The average age at diagnosis of congenital hypothyroidism with nodules was 1.42+/-1.39 months. All detected nodules measured less than 1 cm in diameter. Twenty-two of the 28 infants (78.6%) had only one nodule, while multiple nodules were found in 6 infants (21.4%). Of the 28 infants diagnosed with nodules, 16 underwent thyroid ultrasonography during follow-up and 8 of them (50%) showed no signs of nodules at thyroid ultrasonography. CONCLUSION: The prevalence of thyroid nodules in infants with congenital hypothyroidism was 4.2%. Most thyroid nodules were small in size and benign, disappearing during follow-up observation. We therefore conclude that thyroid nodules in infants with congenital hypothyroidism can simply be observed and do not require direct treatment.

Pathologically Proven Hyperechoic Masses of the Breast on Ultrasound: Differentiation of Malignant and Benign Lesions

OBJECTIVE: The aim of this study was to evaluate the frequency of the characteristic sonographic findings of the pathologically confirmed hyperechoic masses on breast ultrasonography, and clinical and sonographic findings in differentiating the malignant from benign hyperechoic masses. METHODS: One hundred and ninety hyperechoic masses on breast ultrasonogram of which were pathologically confirmed were retrospectively analyzed. The clinical features were reviewed according to patient's age, size of mass, and palpability. The sonographic features were reviewed according to the Breast Imaging Reporting and Data System 4th lexicon: margin, orientation, shaped, and posterior acoustic features. The sonographic features of the benign and malignant masses were statistically analyzed using the chi-square test, the Fisher's exact test, and t-test. RESULTS: The benign masses were 42 cases (79.2%) and the malignant masses were 11 cases (20.8%). Patient age, size of mass, palpability were not significant difference between malignant and benign masses (P=0.684, P=0.377, P=0.746). Mixed hyperechoic, noncircumscribed margin, irregular shape, nonparallel orientation were significantly different for malignant and benign masses (P<0.001, P=0.01, P=0.003, P=0.025). But posterior acoustic features were not statistically different for malignant and benign masses. CONCLUSION: Malignant masses with hyperechogenicity were more likely than benign masses to have mixed hyperechoic, noncircumscribed margin, irregular shape, nonparallel orientation. Therefore, pathologically confirm should be performed hyperechoic masses with suspicious findings.

Aberrant Ovarian Artery Arising from the Common Iliac Artery: Case Report

A 46-year-old Vietnamese woman received embolization therapy in order to control postpartum hemorrhage. Angiography revealed an aberrant ovarian artery arising from the right common iliac artery. Superselective catheterization and subsequent embolization of the aberrant ovarian artery and bilateral uterine arteries were performed. Precise knowledge of the anatomic variations of the ovarian artery is important for successful embolization.

MRI Findings of Intramuscular Foreign Body Injection: A Case Report

There are various types of foreign body reactions, such as inflammation, edema, fluid collection, hematoma, infection, abscess and granulomas. There are various imaging findings according to types of foreign bodies and depending on the lapse of time. Therefore, correct diagnosis of a foreign body reaction is difficult and easily confused with soft tissue neoplasm. The MRI is ideal for the detection of foreign bodies regardless of radiolucency or acoustic impedance. It is especially very useful in the evaluation of the surrounding tissue reaction. The authors report a case of a 26-year-old female patient with both forearm swelling due to self-injection of a mixture of powdered tablets and saline. The lesion shows numerous internal T1 and T2 dark signal intensity micro-spots with surrounding fluid collection, which are diagnosed as foreign bodies with surrounding inflammatory changes during an operation.

Safety and Efficacy of Ultrasound-Guided Fiducial Marker Implantation for CyberKnife Radiation Therapy

OBJECTIVE: To evaluate the safety and technical success rate of an ultrasound-guided fiducial marker implantation in preparation for CyberKnife radiation therapy. MATERIALS AND METHODS: We retrospectively reviewed 270 percutaneous ultrasound-guided fiducial marker implantations in 77 patients, which were performed from June 2008 through March 2011. Of 270 implantations, 104 were implanted in metastatic lymph nodes, 96 were in the liver, 39 were in the pancreas, and 31 were in the prostate. During and after the implantation, major and minor procedure-related complications were documented. We defined technical success as the implantation enabling adequate treatment planning and CT simulation. RESULTS: The major and minor complication rates were 1% and 21%, respectively. One patient who had an implantation in the liver suffered severe abdominal pain, biloma, and pleural effusion, which were considered as major complication. Abdominal pain was the most common complication in 11 patients (14%). Among nine patients who had markers inserted in the prostate, one had transient hematuria for less than 24 hours, and the other experienced transient voiding difficulty. Of the 270 implantations, 261 were successful (97%). The reasons for unsuccessful implantations included migration of fiducial markers (five implantations, 2%) and failure to discriminate the fiducial markers (three implantations, 1%). Among the unsuccessful implantation cases, six patients required additional procedures (8%). CONCLUSION: The symptomatic complications following ultrasound-guided percutaneous implantation of fiducial markers are relatively low. However, careful consideration of the relatively higher rate of migration and discrimination failure is needed when performing ultrasound-guided percutaneous implantations of fiducial markers.

Sonographic Features of Dual Ectopic Thyroid: Report of Two Cases

Ectopic thyroid is an uncommon congenital abnormality, but ectopic thyroid tissue can be present anywhere along the course of the thyroglossal duct and the embryologic descent from the base of the tongue. We report here on two cases with the ultrasonograpic findings of dual ectopy of the thyroid, and these findings were well correlated with the findings of nuclear scintigraphy.