Elastography for the diagnosis of high-suspicion thyroid nodules based on the 2015 American Thyroid Association guidelines: a multicenter study.

BACKGROUND: An accurate diagnosis for high-suspicion nodules based on the 2015 American Thyroid Association (ATA) guidelines would reduce unnecessary invasive examinations. Elastography is a useful tool for discriminating benign and malignant thyroid nodules. The aim of this study is to investigate the diagnostic efficiency of elastography for high-suspicion thyroid nodules based on the 2015 ATA guidelines in the Chinese population. METHODS: Thyroid nodules with high-suspicion characteristics based on the 2015 ATA guidelines were subjected to conventional ultrasound (US) and ultrasound strain elastography (USE) examinations at 12 hospitals from 4 geographic regions across China. Cytology/histology of thyroid nodules was used as a reference method. Receiver operating characteristic (ROC) curves were plotted to evaluate the diagnostic performance of the elasticity score (ES) and strain ratio (SR). Logistic regression analysis was used to determine the predictors of malignancy. RESULTS: Overall, a total of 1445 thyroid nodules (834 malignant, 611 benign) from 12 centers were included in the final analysis. The areas under the curve of the ES and SR were 0.828 and 0.732, respectively. The sensitivity, specificity, accuracy, positive predictive value (PPV) and negative predictive value (NPV) of the ES were 92.4, 60.7, 79.0, 76.3 and 85.5%, respectively, and those of the SR were 81.1, 50.1, 68.9, 65.9 and 67.9%, respectively. The combination of the Thyroid Imaging Reporting and Data System (TI-RADS) and ES led to a significant increase in the sensitivity and NPV (97.1 and 91.9%, respectively) compared with the TI-RADS alone. Logistic regression analysis showed that microcalcifications (OR = 5.290), taller than wide (OR = 12.710), irregular margins (OR = 10.117), extrathyroidal extension (ETE; OR = 6.412), the ES (OR = 3.741) and the SR (OR = 1.083) were independent predictors of malignant thyroid nodules. The sensitivity, specificity, accuracy, PPV and NPV of the ES were all superior in nodules ≥1 cm than in those < 1 cm (95.0% vs 90.4, 68.8% vs 56.8, 85.9% vs 74.4, 85.2% vs 69.9, and 87.8% vs 84.2%, respectively). CONCLUSIONS: Elastography combined with the ES is a valuable tool for the assessment of high-suspicion thyroid nodules based on the 2015 ATA guidelines, especially in nodules ≥1 cm.

Inlfuence of High Density Lipoprotein Cholesterol Upon Carotid Artery Structure and Elasticity：Assessed with Ultrasound Radio Frequency-data Technique / 中国医学影像学杂志

PurposeTo explore the value of ultrasound radio frequency technique in the quantitative evaluation of common carotid artery intima-media thickness (IMT) and elasticity change in patients with dyslipidemia, and to discuss the influence of high density lipoprotein cholesterol (HDL-C) upon carotid artery structure and elasticity function. Materials and Methods A hundred and fifty patients with abnormal serum lipid were selected as case group and further divided into three groups: group A--50 patients with hyperlipidemia and high HDL-C, group B--50 patients with hyperlipidemia and normal HDL-C, group C--50 patients with hyperlipidemia and low HDL-C. Meanwhile, 50 healthy people were enrolled in the study as control group (group D). The ultrasound radio frequency-data technique was employed to analyze the influence of hyperlipidemia and HDL-C upon IMT, CC,β, PWV and AIx.Results The IMT,β, PWV and AIx in group B were higher than those in group D, but group B had lower CC (the differences with statistic significance,t=5.141, 4.219, 4.898, 4.142 and-3.758,P0.05). In patients with hyperlipidemia, the increase of HDL-C led to the reduction of the common carotid artery IMT and wall stiffness and the increase of elasticity and vice versa.Conclusion The ultrasound radio frequency technique could measure the real-time common carotid artery IMT and elasticity automatically and accurately, thus provides reliable quantitative index for the evaluation of early artery structure and change of function in lipid lowering therapy.

Evaluation of quantitative analysis of organization diffusion application in diagnosing liver fibrosis / 中华超声影像学杂志

Objective To explore the best cutoff point of the quantitative analysis of organization diffusion for differentiating liver fibrosis and to assess its diagnostic value.Methods Sixty-five patients with chronic hepatitis B were examined with quantitative analysis of organization diffusion before liver biopsy,and made a ROC analysis of diagnostic test.All cases confirmed by pathology.Results 114.95 was the best cutoff point of the strain average value which was one parameter of the quantitative analysis of organization diffusion,the area under the curve of ROC was 0.950 (P=0.000),and the sensitivity,specificity,accuracy were 92.3%,87.2% and 89.2%,respectively.Conclusions The quantitative analysis of organization diffusion is helpful in diagnosing liver fibrosis.

Comparative study of ultrasound elastosonography with pathology on hepatic fibrosis in patients with chronic hepatitis B / 中华超声影像学杂志

Objective To investigate the value of ultrasound elastosonography in the diagnosis of liver fibrosis. Methods One hundred and twenty patients with chronic hepatitis B were examined by ultrasound elastosonography and given elasticity scores,the correlation coefficient between the elasticity scores and the histologic fibrosis stage was evaluated and its difference in the diagnosis of liver fibrosis was compared. Results The Spearman's correlation coefficient between the elasticity scores and the histologic fibrosis stage was 0. 875,which was highly significant ( P＜0. 01). There was no significantly difference between elasticity scores and fibrosis staging in the diagnosis of liver fibrosis by Marginal Homogeneity (Z=- 1. 144, P = 0. 149). The sensitivity,specificity and accuracy of ultrasonic elastography for diagnosing liver fibrosis were 92. 5%, 85.0%, 90.0%, respectively. Conclusions Elastosonography is helpful for the diagnosis of liver fibrosis.

Logistic regression analysis of ultrasonographic features in thyroid solitary nodular / 中国医学影像技术

Objective To find out the valuable ultrasonographic features for differentiating benign and malignant thyroid solitary nodular, and to apply the binary Logistic regression model in analysis of ultrasonography of thyroid solitary nodular. Methods Two-dimensional ultrasonography was performed in 194 patients with thyroid solitary nodular confirmed with surgical pathology. A Logistic model was obtained on the basis of ultrasonographic features. A receiver operator characteristic (ROC) curve was constructed to assess the performance of the Logistic model. Results Three ultrasonographic features including shape, calcification and heterogeneous texture were finally entered into the Logistic model. The percentage of correct prediction was 91.75%. The area under ROC curve was 0.916±0.035. Conclusion The binary Logistic regression can select the valuable indexes in the differential diagnosis of thyroid solitary nodular. The application of binary Logistic regression model can improve the diagnosis accuracy of thyroid solitary nodular.

Evaluation of grey scale ultrasonography combined with elastography in differentiating benign and malignant thyroid lesions using receiver operating characteristic curves / 中华超声影像学杂志

Objective To evaluate the value of grey scale ultrasonography (US) combined with elastography in the difference diagnosis of benign and malignant thyroid lesions. Methods Sixty-two patients with 81 lesions were examined by grey scale US and elastography preoperatively. All the lesions were confirmed by pathology. According to their features of grey scale ultrasonograms and elastograms, two receiver operating characteristic (ROC) curves were drawn, one for gray ultrasound and one for the combination methods. The area under curve (AUC) of them were made a comparison. Results The cut-off value of the grey scale group was equal or more than 5, the sensitivity,specificity was 60. 0% ,98. 5%. And the cut-off value of grey scale US combined with elastography group was equal or more than 6, the sensitivity, specificity was 80.0%, 89.4%. The AUC of grey scale US was 0.860 and that of the combination group was 0. 916. The difference between them was statistically significant Z = - 7. 863, P = 0. 000). Conclusions The grey scale US combined with elastography could improve sensitivity and decrease omission diagnose rate. It may be more helpful in the difference diagnosis of malignant from benign thyroid lesions.