Role of Duplex Power Doppler Ultrasound in Differentiation between Malignant and Benign Thyroid Nodules.
10.3348/kjr.2010.11.6.594
- Author:
Oktay ALGIN
1
;
Efnan ALGIN
;
Gokhan GOKALP
;
Gokhan OCAKOGLU
;
Cuneyt ERDOGAN
;
Ozlem SARAYDAROGLU
;
Ercan TUNCEL
Author Information
1. Department of Radiology, Ataturk Training and Research Hospital Bilkent, Ankara, Turkey. droktayalgin@gmail.com
- Publication Type:Original Article
- Keywords:
Thyroid cancer;
Thyroid nodules;
Power Doppler ultrasonography, RI, PI
- MeSH:
Adult;
Aged;
Biopsy, Fine-Needle;
Chi-Square Distribution;
Diagnosis, Differential;
Female;
Humans;
Male;
Middle Aged;
Prospective Studies;
ROC Curve;
Sensitivity and Specificity;
Statistics, Nonparametric;
Thyroid Neoplasms/pathology/*ultrasonography;
Thyroid Nodule/pathology/*ultrasonography;
*Ultrasonography, Doppler, Duplex;
Ultrasonography, Interventional
- From:Korean Journal of Radiology
2010;11(6):594-602
- CountryRepublic of Korea
- Language:English
-
Abstract:
OBJECTIVE: To evaluate the usage of duplex power Doppler ultrasound (PDUS) for the differentiation of benign and malignant thyroid nodules. MATERIALS AND METHODS: We prospectively examined 77 thyroid nodules in 60 patients undergoing ultrasound-guided fine needle aspiration biopsy (FNAB). Each nodule was described according to size, inner structure, borders, parenchymal echogenicity, peripheral halo formation, and the presence of calcification (B-mode ultrasound findings). Vascularity as determined by PDUS imaging was defined as non-vascular, peripheral, central, or of mixed type. For each nodule, the pulsatility index (PI) and resistive index (RI) values were obtained. Results of FNAB and surgical pathological examination (if available) were used as a proof of final diagnosis to categorize all nodules as benign or malignant. A receiver operating characteristic (ROC) curve analysis was performed to establish cut-off, sensitivity, and specificity values associated with RI-PI values. RESULTS: A significant relationship was observed between malignancy and irregular margins, microcalcifications, and hypoechogenicity on ultrasound examination (p < 0.05). The pattern of vascularity as determined by PDUS analysis was not a statistically significant criterion to suggest benign or malignant disease in this study (p > 0.05). The central, peripheral, and mean RI-PI values were higher in malignant nodules when compared to the other cytologies (p < 0.05). CONCLUSION: Vascularity is not a useful parameter for distinguishing malignant from benign thyroid nodules. However, RI and PI values are useful in distinguishing malignant from benign thyroid nodules.
