Use of the ultrasound-based total malignancy score in the management of thyroid nodules
Ultrasonography.2019;38(2):188-189. doi:10.14366/usg.18068
Ultrasonography
2002 (v1, n1) to Present ISSN: 1671-8925
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Ultrasonography.2019;38(2):181-187. doi:10.14366/usg.18024
Ultrasonography is a generally accepted imaging technique for diagnosing and monitoring cystic renal lesions. The widely used Bosniak classification (I-IV) categorizes renal cystic lesions into five distinctive groups according to ultrasonography and computed tomography (CT) image criteria. For solid renal lesions, determination of vascularity is discriminatory for malignancy in most instances. In indeterminate cases, contrast-enhanced ultrasound (CEUS) and magnetic resonance imaging/CT-ultrasound image fusion are able to detect and characterize difficult pathologies, with superior performance to either technique alone. In contrast to multislice CT (MS-CT), ultrasound image fusion is a real-time imaging technique that can be used in combination with other cross-sectional imaging modalities. This technical note describes state-of-the-art image fusion of CEUS and MS-CT to detect and characterize unclear renal pathologies.
Classification ; Pathology ; Ultrasonography
Classification ; Pathology ; Ultrasonography
Ultrasonography.2019;38(2):172-180. doi:10.14366/usg.18012
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.
Breast Neoplasms ; Breast ; Classification ; Education ; Humans ; Korea ; Mammography ; Mass Screening ; Observer Variation ; Quality Control ; Research Personnel ; Ultrasonography
Breast Neoplasms ; Breast ; Classification ; Education ; Humans ; Korea ; Mammography ; Mass Screening ; Observer Variation ; Quality Control ; Research Personnel ; Ultrasonography
Ultrasonography.2019;38(2):166-171. doi:10.14366/usg.18033
PURPOSE: We compared the efficacy and safety of two ethanol ablation techniques-ethanol aspiration and ethanol retention-for benign cystic thyroid nodules. METHODS: From October 2008 to September 2013, 113 patients who were treated using the ethanol aspiration technique (February 2008 to December 2010) and 108 patients who were treated using the ethanol retention technique (January 2011 to September 2013) were enrolled (male:female ratio, 53:168; mean age, 48.1 years; range, 18 to 80 years). The patient sample had 94 cystic and 127 predominantly cystic thyroid nodules. The volume reduction ratio (VRR) at the last follow-up, improvements in symptoms and cosmetic scores, vascularity, pain, and major complications were evaluated and compared between the ethanol aspiration group and ethanol retention group. We also performed a subgroup analysis according to the proportion of the solid component, in which VRR, symptom and cosmetic scores, and therapeutic success were compared. RESULTS: No statistically significant difference in VRR was found between the ethanol retention group and the ethanol aspiration group (83.2%±32.8% vs. 86.1%±18.4%, P=0.416) while patients who underwent the retention technique were more likely to experience pain after treatment (P=0.001). VRR, symptom and cosmetic scores, and therapeutic success did not significantly differ between techniques in either group in the subgroup analysis. CONCLUSION: The ethanol aspiration technique may be preferable to the ethanol retention technique for treating benign cystic and predominantly cystic thyroid nodules, because a comparable VRR can be expected with less pain.
Ethanol ; Follow-Up Studies ; Humans ; Thyroid Gland ; Thyroid Nodule ; Ultrasonography
Ethanol ; Follow-Up Studies ; Humans ; Thyroid Gland ; Thyroid Nodule ; Ultrasonography
Non-enhancing gliomas: does intraoperative ultrasonography improve resections?
Ultrasonography.2019;38(2):156-165. doi:10.14366/usg.18032
PURPOSE: Non-enhancing diffuse gliomas are a challenging surgical proposition. Delineation of tumor extent on preoperative imaging and intraoperative visualization are often difficult. METHODS: We retrospectively analyzed all cases of non-enhancing gliomas that were operated on using navigated 3-dimensional ultrasonography (US). tumor delineation (good, moderate, or poor) on preoperative magnetic resonance imaging (MRI) and intraoperative US was compared. Post-resection US findings with respect to residual tumor status were compared to the postoperative imaging findings. The extent of resection was calculated and recorded. RESULTS: There were 55 gliomas (43 high-grade, 12 low-grade). Forty were close to eloquent areas. The pre-resection concordance of MRI with US was 56%, with US defining more tumors as well-delineated (n=26) than MRI (n=13). US was used for resection control in 50 cases. Gross tumor resection was achieved in 24 cases (51%). US correctly predicted the residual tumor status in 78% of cases. The use of US led to radical resections even in some tumors preoperatively deemed to be unresectable. However, eloquent location was the only independent predictor of the extent of resection. CONCLUSION: Intraoperative US is a useful tool for guiding resection of non-enhancing gliomas. It may be better than MRI for delineating these tumors, and may thereby facilitate improved resection of these otherwise poorly delineated tumors. However, functional boundaries remain the main limiting factor for achieving complete resection of non-enhancing gliomas.
Glioma ; Magnetic Resonance Imaging ; Neoplasm, Residual ; Retrospective Studies ; Ultrasonography
Glioma ; Magnetic Resonance Imaging ; Neoplasm, Residual ; Retrospective Studies ; Ultrasonography
Ultrasonography.2019;38(2):149-155. doi:10.14366/usg.18028
PURPOSE: The purpose of this study was to externally validate the diagnostic usefulness of transrectal ultrasound (TRUS) or transvaginal ultrasound (TVUS)-guided biopsy for pelvic masses, and to analyze the diagnostic performance of these methods in oncologic patients. METHODS: A consecutive series of 30 patients who underwent TRUS- or TVUS-guided biopsy for pelvic masses was included. Tissue samples were obtained using an 18-gauge core biopsy needle under local anesthesia for lesions detected on computed tomography or magnetic resonance imaging. We analyzed the rates of diagnostic biopsies upon pathologic examination and biopsy-related major complications requiring treatment. In diagnostic biopsy cases, the performance was also investigated for all patients and patients with underlying malignancy. RESULTS: The diagnostic biopsy rate was 93.3% (28 of 30) for all patients and 95.0% (19 of 20) for oncologic patients. No patients had major complications. In diagnostic biopsies, the sensitivity, specificity, positive and negative predictive value, and accuracy for identifying malignancy were 100% (17 of 17), 72.7% (8 of 11), 85.0% (17 of 20), 100% (8 of 8), and 89.3% (25 of 28) for all patients and 100% (14 of 14), 60.0% (3 of 5), 87.5% (14 of 16), 100% (3 of 3), and 89.5% (17 of 19) for oncologic patients, respectively. CONCLUSION: This study externally validated the feasibility and safety of TRUS- or TVUS-guided biopsy. In addition, these techniques appear to enable accurate pathologic diagnoses of pelvic masses in oncologic patients to be made safely and relatively noninvasively.
Anesthesia, Local ; Biopsy ; Diagnosis ; Humans ; Magnetic Resonance Imaging ; Needles ; Pelvis ; Sensitivity and Specificity ; Ultrasonography
Anesthesia, Local ; Biopsy ; Diagnosis ; Humans ; Magnetic Resonance Imaging ; Needles ; Pelvis ; Sensitivity and Specificity ; Ultrasonography
Ultrasonography.2019;38(2):143-148. doi:10.14366/usg.18030
PURPOSE: This study aimed to develop a multi-channel near-infrared spectroscopy (NIRS) and ultrasonography (USG) fusion imaging system for imaging prostate cancer and to verify its diagnostic capability by applying the hybrid imaging system to a prostate cancer phantom. METHODS: A multi-channel NIRS system using the near-infrared 785-nm wavelength with 12 channels and four detectors was developed. After arranging the optical fibers around a USG transducer, we performed NIRS imaging and grayscale USG imaging simultaneously. Fusion imaging was obtained by processing incoming signals and the spatial reconstruction of NIRS, which corresponded with grayscale USG acquired at the same time. The NIRS-USG hybrid system was applied to a silicone-based optical phantom of the prostate gland containing prostate cancer to verify its diagnostic capability qualitatively. RESULTS: The NIRS-USG hybrid imaging system for prostate cancer imaging simultaneously provided anatomical and optical information with 2-dimensional registration. The hybrid imaging system showed more NIR attenuation over the prostate cancer model than over the model of normal prostate tissue. Its diagnostic capability to discriminate a focal area mimicking the optical properties of prostate cancer from the surrounding background mimicking the optical properties of normal prostate tissue was verified by applying the hybrid system to a silicone-based optical phantom of prostate cancer. CONCLUSION: This study successfully demonstrated that the NIRS-USG hybrid system may serve as a new imaging method for improving the diagnostic accuracy of prostate cancer, with potential utility for future clinical applications.
Diagnosis ; Methods ; Optical Fibers ; Prostate ; Prostatic Neoplasms ; Spectroscopy, Near-Infrared ; Transducers ; Ultrasonography
Diagnosis ; Methods ; Optical Fibers ; Prostate ; Prostatic Neoplasms ; Spectroscopy, Near-Infrared ; Transducers ; Ultrasonography
Ultrasonography.2019;38(2):135-142. doi:10.14366/usg.18040
High-intensity focused ultrasound (HIFU) is a promising ablation technique for benign thyroid nodules. Current evidence has found good short- to medium-term outcomes, similar to those of better-established ablation techniques such as radiofrequency and laser ablation. The fact that it does not require insertion of a needle into the target makes HIFU a truly non-invasive treatment. Although it is not without risks, its low risk profile makes it an attractive alternative to surgery. There is much room for future development, starting from expanding the current indications to enhancing energy delivery. Relapsed Graves disease and papillary microcarcinoma are diseases that can benefit from HIFU treatment. Its role in the mediation of immune responses and synergistic effects with immunotherapy are promising in the fight against metastatic cancers.
Ablation Techniques ; Goiter, Nodular ; Graves Disease ; High-Intensity Focused Ultrasound Ablation ; Hyperthermia, Induced ; Immunotherapy ; Laser Therapy ; Needles ; Negotiating ; Thyroid Diseases ; Thyroid Gland ; Thyroid Nodule ; Ultrasonography ; Ultrasonography, Interventional
Ablation Techniques ; Goiter, Nodular ; Graves Disease ; High-Intensity Focused Ultrasound Ablation ; Hyperthermia, Induced ; Immunotherapy ; Laser Therapy ; Needles ; Negotiating ; Thyroid Diseases ; Thyroid Gland ; Thyroid Nodule ; Ultrasonography ; Ultrasonography, Interventional
Summary of the 2017 thyroid radiofrequency ablation guideline and comparison with the 2012 guideline
Ultrasonography.2019;38(2):125-134. doi:10.14366/usg.18044
Radiofrequency ablation (RFA) is a new, minimally invasive modality that serves as an alternative to surgery in patients with thyroid tumors. The Task Force Committee of the Korean Society of Thyroid Radiology developed recommendations for the optimal use of RFA for thyroid tumors in 2012 and revised them in 2017. Herein, we review and summarize the 2017 thyroid RFA guideline and compare it with the 2012 thyroid RFA guideline.
Advisory Committees ; Catheter Ablation ; Humans ; Thyroid Gland ; Thyroid Neoplasms ; Thyroid Nodule ; Ultrasonography
Advisory Committees ; Catheter Ablation ; Humans ; Thyroid Gland ; Thyroid Neoplasms ; Thyroid Nodule ; Ultrasonography
Ultrasound elastography of the thyroid: principles and current status
Ultrasonography.2019;38(2):106-124. doi:10.14366/usg.18037
Ultrasound (US) elastography has been introduced as a non-invasive technique for evaluating thyroid diseases. This paper presents a detailed description of the technical principles, peculiarities, and limitations of US elastography techniques, including strain elastography and shear-wave elastography. This review was conducted from a clinical perspective, and aimed to assess the usefulness of US elastography for thyroid diseases in specific clinical scenarios. Although its main focus is on thyroid nodules, the applications of US elastography for other thyroid diseases, such as diffuse thyroid diseases and thyroiditis, are also presented. Furthermore, unresolved questions and directions for future research are also discussed.
Elasticity Imaging Techniques ; Thyroid Diseases ; Thyroid Gland ; Thyroid Nodule ; Thyroiditis ; Ultrasonography
Elasticity Imaging Techniques ; Thyroid Diseases ; Thyroid Gland ; Thyroid Nodule ; Thyroiditis ; Ultrasonography
Country
Republic of Korea
Publisher
Korean Society of Ultrasound in Medicine
ElectronicLinks
http://e-ultrasonography.orgEditor-in-chief
Yonsei University, Korea
office@ultrasound.or.kr
Abbreviation
Ultrasonography
Vernacular Journal Title
ISSN
2288-5919
EISSN
2288-5943
Year Approved
2007
Current Indexing Status
Currently Indexed
Start Year
2017
Description
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