Giovanni Turtulici, Presenter: Nothing to Disclose

Davide Orlandi MD, Abstract Co-Author: Nothing to Disclose

Emanuele Fabbro MD, Abstract Co-Author: Nothing to Disclose

Chiara Martini MChir, Abstract Co-Author: Nothing to Disclose

Giacomo Garlaschi MD, Abstract Co-Author: Nothing to Disclose

Enzo Silvestri MD, Abstract Co-Author: Nothing to Disclose

CEUS has been proven to be a valuable tool in the quantitative assessment of nodules in different organs. Our purpose was to assess the role of CEUS quantitative evaluation of histologically-proven thyroid nodules, also estimating the clinical value of such a method in differentiating benign from malignant ones.

Thirty-two thyroid nodules in 32 patients (29 women, mean age 48±8 years), selected for their cytological features (14 Thy2; 11 Thy3; 5 Thy4; 2 Thy5), were studied, using a US scanner (MyLab 70XvG, Esaote, Italy) equipped with a linear probe (7-12 MHz). CEUS was performed after bolus injection of SonoVue (4.8 ml) using a nondestructive US mode. CEUS-video clips were digitally recorded and analyzed (Q-Contrast V.4.0, Bracco, Italy) using time-intensity curves analysis within selected regions-of-interest and color maps. Nodules and healthy thyroid values of contrast enhancement peak (Peak) and time to peak (TTP) and their ratios were calculated. Cytological correlations were obtained in all cases using fine needle aspiration (FNAC), also having histological confirmation of cancer or indeterminate nodules (Thy3-4-5). Pearson's statistics were used.

Histological examination revealed 25 benign and 7 malignant thyroid nodules. Mean values of Peak index (Peak thyroid/Peak nodule) and TTP index (TTP thyroid/TTP nodule) were 1,784±0,600 (range 1,125-2,612) and 0,555±0,347 (range 0,220-1,157) for malignant nodules and 1,093±0,521 (range 0,429-2,925) and 0,977±0,131 (range 0,697-1,231) for benign ones, respectively. Setting a threshold at 0.600 for TTP index, sensitivity was 66%, specificity was 100%, accuracy was 94% and positive predictive value was 100%. Peak-TTP correlation observed among nodules with indeterminate cytology (Ty3) and malignant nodules (Ty4-Ty5) was 73% and 72% respectively.  

Using a threshold of 0.600 for TTP index when performing CEUS evaluation of thyroid nodules allows for achieving high levels of sensitivity and specificity in differentiating benign from malignant nodules. CEUS also shows good correlation with cytological and histological features of such lesions.

CEUS quantitative analysis of thyroid nodules can help improving specificity and accuracy of such an imaging technique in clinical practice.

Turtulici, G, Orlandi, D, Fabbro, E, Martini, C, Garlaschi, G, Silvestri, E, Contrast-enhanced Ultrasound (CEUS) Quantitative Evaluation of Histologically Proven Thyroid Nodules.  Radiological Society of North America 2011 Scientific Assembly and Annual Meeting, November 26 - December 2, 2011 ,Chicago IL. http://archive.rsna.org/2011/11034465.html