Diagnostic value of high-resolution B-mode and power-mode sonography in the follow-up of thyroid cancer
Objective: Ultrasonography is an established diagnostic modality in the follow-up of thyroid cancer. Color flow Doppler has been proposed by some authors as an additional tool for differentiating benign from malignant cervical lesions in various types of head and neck cancer. Over the last few years...
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| Veröffentlicht in: | European journal of ultrasound 2003-02, Vol.16 (3), p.191-206 |
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| creator | Görges, Rainer Eising, E.G Fotescu, D Renzing-Köhler, K Frilling, A Schmid, K.W Bockisch, A Dirsch, O |
| description | Objective: Ultrasonography is an established diagnostic modality in the follow-up of thyroid cancer. Color flow Doppler has been proposed by some authors as an additional tool for differentiating benign from malignant cervical lesions in various types of head and neck cancer. Over the last few years, a new generation of high-resolution ultrasound platforms with the ‘power-mode’ feature has become available, that also enables the imaging of small vessel blood flow. The objective of our study was to find ways of optimizing the differentiation of benign and malignant cervical tumors in thyroid cancer follow-up by means of sonography.
Methods: Hundred and twelve cervical lesions in 90 patients with thyroid cancer were evaluated by high-end ultrasonography (Sonoline™ Elegra, Siemens) using a small-part transducer (7.5 L 40, Siemens). B-mode sonography was performed at a frequency of 8 MHz. The Solbiati index (SI= ratio of largest to smallest diameter), configuration, echogenicity, intranodular structures, and margins were assessed. Perinodular and intranodular blood flow was evaluated by color flow Doppler (PRF 1250 Hz for conventional color flow Doppler, 868 Hz for power-mode Doppler). Possible malignancy was validated by histology, cytology, scintigraphy, and follow-up. Thirty five lesions were benign (diameter 0.4–3.0 cm) and 77 were malignant (0.4–5.4 cm). The patients were randomized into a test group and a learning group to determine the diagnostic value of various ultrasound criteria by means of statistical analysis. In the learning group, decision rules based on the dichotomized criteria were developed using a logistic regression model. Sensitivity and specificity of these decision rules were then evaluated in the test group.
Results: The presence of an echocomplex pattern or irregular hyperechoic small intranodular structures (criterion A) and the presence of an irregular diffuse intranodular blood flow (criterion B) are the best indicators of malignancy, whereas an SI≫2 is highly indicative of benign changes. Color flow Doppler is a useful addition to B-mode scanning for distinguishing benign and malignant neoplasms in the follow-up of thyroid cancer. Power-mode Doppler sonography significantly improves imaging of perinodular and intranodular blood flow when compared with conventional color flow Doppler.
Conclusion: We propose the following decision rules based on a combination of the criteria above: (A) and (B) fulfilled: malignant, if SI≤4; (B) but |
| doi_str_mv | 10.1016/S0929-8266(02)00073-3 |
| format | Article |
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Methods: Hundred and twelve cervical lesions in 90 patients with thyroid cancer were evaluated by high-end ultrasonography (Sonoline™ Elegra, Siemens) using a small-part transducer (7.5 L 40, Siemens). B-mode sonography was performed at a frequency of 8 MHz. The Solbiati index (SI= ratio of largest to smallest diameter), configuration, echogenicity, intranodular structures, and margins were assessed. Perinodular and intranodular blood flow was evaluated by color flow Doppler (PRF 1250 Hz for conventional color flow Doppler, 868 Hz for power-mode Doppler). Possible malignancy was validated by histology, cytology, scintigraphy, and follow-up. Thirty five lesions were benign (diameter 0.4–3.0 cm) and 77 were malignant (0.4–5.4 cm). The patients were randomized into a test group and a learning group to determine the diagnostic value of various ultrasound criteria by means of statistical analysis. In the learning group, decision rules based on the dichotomized criteria were developed using a logistic regression model. Sensitivity and specificity of these decision rules were then evaluated in the test group.
Results: The presence of an echocomplex pattern or irregular hyperechoic small intranodular structures (criterion A) and the presence of an irregular diffuse intranodular blood flow (criterion B) are the best indicators of malignancy, whereas an SI≫2 is highly indicative of benign changes. Color flow Doppler is a useful addition to B-mode scanning for distinguishing benign and malignant neoplasms in the follow-up of thyroid cancer. Power-mode Doppler sonography significantly improves imaging of perinodular and intranodular blood flow when compared with conventional color flow Doppler.
Conclusion: We propose the following decision rules based on a combination of the criteria above: (A) and (B) fulfilled: malignant, if SI≤4; (B) but not (A) fulfilled: malignant, if SI≤3; (A) but not (B) fulfilled: malignant, if SI≤2; neither (A) nor (B) fulfilled: malignant, if SI≈1 (sensitivity: 90%; specificity: 82%; accuracy 88%).</description><identifier>ISSN: 0929-8266</identifier><identifier>DOI: 10.1016/S0929-8266(02)00073-3</identifier><identifier>PMID: 12573788</identifier><language>eng</language><publisher>Shannon: Elsevier Ireland Ltd</publisher><subject>Adult ; Aged ; Aged, 80 and over ; B-mode ; Biological and medical sciences ; Color flow Doppler ; Endocrine glands ; Female ; Follow-up ; Follow-Up Studies ; Humans ; Investigative techniques, diagnostic techniques (general aspects) ; Male ; Medical sciences ; Middle Aged ; Power-mode ; Sonography ; Thyroid cancer ; Thyroid Gland - diagnostic imaging ; Thyroid Neoplasms - diagnostic imaging ; Ultrasonic investigative techniques ; Ultrasonography - methods ; Ultrasonography, Doppler, Color</subject><ispartof>European journal of ultrasound, 2003-02, Vol.16 (3), p.191-206</ispartof><rights>2002 Elsevier Science Ireland Ltd</rights><rights>2003 INIST-CNRS</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c403t-5d6e019b18b3c9dd11578d13948b836be7cb07e34d1fdb4817e29cc9c81938ae3</citedby><cites>FETCH-LOGICAL-c403t-5d6e019b18b3c9dd11578d13948b836be7cb07e34d1fdb4817e29cc9c81938ae3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,27901,27902</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=14535262$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/12573788$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Görges, Rainer</creatorcontrib><creatorcontrib>Eising, E.G</creatorcontrib><creatorcontrib>Fotescu, D</creatorcontrib><creatorcontrib>Renzing-Köhler, K</creatorcontrib><creatorcontrib>Frilling, A</creatorcontrib><creatorcontrib>Schmid, K.W</creatorcontrib><creatorcontrib>Bockisch, A</creatorcontrib><creatorcontrib>Dirsch, O</creatorcontrib><title>Diagnostic value of high-resolution B-mode and power-mode sonography in the follow-up of thyroid cancer</title><title>European journal of ultrasound</title><addtitle>Eur J Ultrasound</addtitle><description>Objective: Ultrasonography is an established diagnostic modality in the follow-up of thyroid cancer. Color flow Doppler has been proposed by some authors as an additional tool for differentiating benign from malignant cervical lesions in various types of head and neck cancer. Over the last few years, a new generation of high-resolution ultrasound platforms with the ‘power-mode’ feature has become available, that also enables the imaging of small vessel blood flow. The objective of our study was to find ways of optimizing the differentiation of benign and malignant cervical tumors in thyroid cancer follow-up by means of sonography.
Methods: Hundred and twelve cervical lesions in 90 patients with thyroid cancer were evaluated by high-end ultrasonography (Sonoline™ Elegra, Siemens) using a small-part transducer (7.5 L 40, Siemens). B-mode sonography was performed at a frequency of 8 MHz. The Solbiati index (SI= ratio of largest to smallest diameter), configuration, echogenicity, intranodular structures, and margins were assessed. Perinodular and intranodular blood flow was evaluated by color flow Doppler (PRF 1250 Hz for conventional color flow Doppler, 868 Hz for power-mode Doppler). Possible malignancy was validated by histology, cytology, scintigraphy, and follow-up. Thirty five lesions were benign (diameter 0.4–3.0 cm) and 77 were malignant (0.4–5.4 cm). The patients were randomized into a test group and a learning group to determine the diagnostic value of various ultrasound criteria by means of statistical analysis. In the learning group, decision rules based on the dichotomized criteria were developed using a logistic regression model. Sensitivity and specificity of these decision rules were then evaluated in the test group.
Results: The presence of an echocomplex pattern or irregular hyperechoic small intranodular structures (criterion A) and the presence of an irregular diffuse intranodular blood flow (criterion B) are the best indicators of malignancy, whereas an SI≫2 is highly indicative of benign changes. Color flow Doppler is a useful addition to B-mode scanning for distinguishing benign and malignant neoplasms in the follow-up of thyroid cancer. Power-mode Doppler sonography significantly improves imaging of perinodular and intranodular blood flow when compared with conventional color flow Doppler.
Conclusion: We propose the following decision rules based on a combination of the criteria above: (A) and (B) fulfilled: malignant, if SI≤4; (B) but not (A) fulfilled: malignant, if SI≤3; (A) but not (B) fulfilled: malignant, if SI≤2; neither (A) nor (B) fulfilled: malignant, if SI≈1 (sensitivity: 90%; specificity: 82%; accuracy 88%).</description><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>B-mode</subject><subject>Biological and medical sciences</subject><subject>Color flow Doppler</subject><subject>Endocrine glands</subject><subject>Female</subject><subject>Follow-up</subject><subject>Follow-Up Studies</subject><subject>Humans</subject><subject>Investigative techniques, diagnostic techniques (general aspects)</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Power-mode</subject><subject>Sonography</subject><subject>Thyroid cancer</subject><subject>Thyroid Gland - diagnostic imaging</subject><subject>Thyroid Neoplasms - diagnostic imaging</subject><subject>Ultrasonic investigative techniques</subject><subject>Ultrasonography - methods</subject><subject>Ultrasonography, Doppler, Color</subject><issn>0929-8266</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2003</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFkE1P3DAQhn0o4vsntPIFRA8BO45j-4RgWz4kJA7Qs-XYk41RNg52Atp_34RdwZHTaEbPzLx6EPpJyTkltLx4IipXmczL8ozkvwkhgmXsB9r_HO-hg5ReyMQWhO-iPZpzwYSU-2j5x5tlF9LgLX4z7Qg41LjxyyaLkEI7Dj50-DpbBQfYdA734R3ipk2hC8to-maNfYeHBnAd2ja8Z2M_HxmadQzeYWs6C_EI7dSmTXC8rYfo383f58Vd9vB4e7-4eshsQdiQcVcCoaqismJWOUcpF9JRpgpZSVZWIGxFBLDC0dpVhaQCcmWtspIqJg2wQ3S6udvH8DpCGvTKJwttazoIY9KCEcK5zL8FqRRcCDWDfAPaGFKKUOs--pWJa02JnvXrD_169qxJrj_0azbt_do-GKsVuK-trfsJONkCJlnT1nES5dMXV3DG83IOcLnhYPL25iHqZD1MUp2PYAftgv8myn8dkqQb</recordid><startdate>200302</startdate><enddate>200302</enddate><creator>Görges, Rainer</creator><creator>Eising, E.G</creator><creator>Fotescu, D</creator><creator>Renzing-Köhler, K</creator><creator>Frilling, A</creator><creator>Schmid, K.W</creator><creator>Bockisch, A</creator><creator>Dirsch, O</creator><general>Elsevier Ireland Ltd</general><general>Elsevier</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QO</scope><scope>8FD</scope><scope>FR3</scope><scope>P64</scope><scope>7X8</scope></search><sort><creationdate>200302</creationdate><title>Diagnostic value of high-resolution B-mode and power-mode sonography in the follow-up of thyroid cancer</title><author>Görges, Rainer ; Eising, E.G ; Fotescu, D ; Renzing-Köhler, K ; Frilling, A ; Schmid, K.W ; Bockisch, A ; Dirsch, O</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c403t-5d6e019b18b3c9dd11578d13948b836be7cb07e34d1fdb4817e29cc9c81938ae3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2003</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>B-mode</topic><topic>Biological and medical sciences</topic><topic>Color flow Doppler</topic><topic>Endocrine glands</topic><topic>Female</topic><topic>Follow-up</topic><topic>Follow-Up Studies</topic><topic>Humans</topic><topic>Investigative techniques, diagnostic techniques (general aspects)</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Power-mode</topic><topic>Sonography</topic><topic>Thyroid cancer</topic><topic>Thyroid Gland - diagnostic imaging</topic><topic>Thyroid Neoplasms - diagnostic imaging</topic><topic>Ultrasonic investigative techniques</topic><topic>Ultrasonography - methods</topic><topic>Ultrasonography, Doppler, Color</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Görges, Rainer</creatorcontrib><creatorcontrib>Eising, E.G</creatorcontrib><creatorcontrib>Fotescu, D</creatorcontrib><creatorcontrib>Renzing-Köhler, K</creatorcontrib><creatorcontrib>Frilling, A</creatorcontrib><creatorcontrib>Schmid, K.W</creatorcontrib><creatorcontrib>Bockisch, A</creatorcontrib><creatorcontrib>Dirsch, O</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Biotechnology Research Abstracts</collection><collection>Technology Research Database</collection><collection>Engineering Research Database</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>MEDLINE - Academic</collection><jtitle>European journal of ultrasound</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Görges, Rainer</au><au>Eising, E.G</au><au>Fotescu, D</au><au>Renzing-Köhler, K</au><au>Frilling, A</au><au>Schmid, K.W</au><au>Bockisch, A</au><au>Dirsch, O</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Diagnostic value of high-resolution B-mode and power-mode sonography in the follow-up of thyroid cancer</atitle><jtitle>European journal of ultrasound</jtitle><addtitle>Eur J Ultrasound</addtitle><date>2003-02</date><risdate>2003</risdate><volume>16</volume><issue>3</issue><spage>191</spage><epage>206</epage><pages>191-206</pages><issn>0929-8266</issn><abstract>Objective: Ultrasonography is an established diagnostic modality in the follow-up of thyroid cancer. Color flow Doppler has been proposed by some authors as an additional tool for differentiating benign from malignant cervical lesions in various types of head and neck cancer. Over the last few years, a new generation of high-resolution ultrasound platforms with the ‘power-mode’ feature has become available, that also enables the imaging of small vessel blood flow. The objective of our study was to find ways of optimizing the differentiation of benign and malignant cervical tumors in thyroid cancer follow-up by means of sonography.
Methods: Hundred and twelve cervical lesions in 90 patients with thyroid cancer were evaluated by high-end ultrasonography (Sonoline™ Elegra, Siemens) using a small-part transducer (7.5 L 40, Siemens). B-mode sonography was performed at a frequency of 8 MHz. The Solbiati index (SI= ratio of largest to smallest diameter), configuration, echogenicity, intranodular structures, and margins were assessed. Perinodular and intranodular blood flow was evaluated by color flow Doppler (PRF 1250 Hz for conventional color flow Doppler, 868 Hz for power-mode Doppler). Possible malignancy was validated by histology, cytology, scintigraphy, and follow-up. Thirty five lesions were benign (diameter 0.4–3.0 cm) and 77 were malignant (0.4–5.4 cm). The patients were randomized into a test group and a learning group to determine the diagnostic value of various ultrasound criteria by means of statistical analysis. In the learning group, decision rules based on the dichotomized criteria were developed using a logistic regression model. Sensitivity and specificity of these decision rules were then evaluated in the test group.
Results: The presence of an echocomplex pattern or irregular hyperechoic small intranodular structures (criterion A) and the presence of an irregular diffuse intranodular blood flow (criterion B) are the best indicators of malignancy, whereas an SI≫2 is highly indicative of benign changes. Color flow Doppler is a useful addition to B-mode scanning for distinguishing benign and malignant neoplasms in the follow-up of thyroid cancer. Power-mode Doppler sonography significantly improves imaging of perinodular and intranodular blood flow when compared with conventional color flow Doppler.
Conclusion: We propose the following decision rules based on a combination of the criteria above: (A) and (B) fulfilled: malignant, if SI≤4; (B) but not (A) fulfilled: malignant, if SI≤3; (A) but not (B) fulfilled: malignant, if SI≤2; neither (A) nor (B) fulfilled: malignant, if SI≈1 (sensitivity: 90%; specificity: 82%; accuracy 88%).</abstract><cop>Shannon</cop><pub>Elsevier Ireland Ltd</pub><pmid>12573788</pmid><doi>10.1016/S0929-8266(02)00073-3</doi><tpages>16</tpages></addata></record> |
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| subjects | Adult Aged Aged, 80 and over B-mode Biological and medical sciences Color flow Doppler Endocrine glands Female Follow-up Follow-Up Studies Humans Investigative techniques, diagnostic techniques (general aspects) Male Medical sciences Middle Aged Power-mode Sonography Thyroid cancer Thyroid Gland - diagnostic imaging Thyroid Neoplasms - diagnostic imaging Ultrasonic investigative techniques Ultrasonography - methods Ultrasonography, Doppler, Color |
| title | Diagnostic value of high-resolution B-mode and power-mode sonography in the follow-up of thyroid cancer |
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