Quantitative contrast-enhanced ultrasound in differential diagnosis of benign and malignant thyroid nodules

Quantitative contrast-enhanced ultrasound was performed in 154 thyroid nodules. Papillary thyroid cancer was histologically proven in 64 cases, follicular thyroid cancer - in 9, follicular adenoma - in 56, colloid nodules - in 12, pseudonodules in autoimmune thyroid disease - in 13. Examinations was done using DC-8 scanner (Mindray, China) with a multifrequency linearprobe (7.5-15.0 MHz) in a specialized mode with a low mechanical index (<0.10). SonoVue ultrasound contrast agent (2.4 ml) was used for examinations. The quantitative analysis was performed with built in ContrastQA software in post-processing mode. Quantitative parameters of time-intensity curve (time to peak intensity (TPI) (s), peak intensity (PI) (dB), half of descending time (DT/2) (s), contrast descending velocity for 30 s after peak intensity (DV) (dB/s)) were analyzed. Quantitative parameters were obtained for thyroid nodules and adjacent parenchyma. Corresponding indices and difference were calculated: TPI index (TPI parenchyma/TPI nodule), PI index (PI parenchyma/PI nodule), DT/2 index (DT/2 parenchyma/DT/2 nodule), DV index (DV parenchyma/DV nodule), and DV difference (DV parenchyma - DV nodule). Statistically significant differences were found for the following parameters between groups of benign and malignant nodules (P ≤ 0.05): PI nodule, PI parenchyma, DT/2 nodule, DT/2 index, DV nodule, DV index, and DV difference. The most accurate parameters for thyroid cancer diagnosis were: DT/2 index, DV index, and DV difference. The test “DT/2 index > 1.028 - thyroid cancer” was characterized by sensitivity of 86.1%, specificity of 85.2%, positive predictive value of 87.7%, negative predictive value of 83.4%, and AUC of 0.872. The test “DV index ≤ 0.895 - thyroid cancer” was characterized by sensitivity of 66.7%, specificity of 95.1%, positive predictive value of 94.3%, negative predictive value of 70.0%, and AUC of 0.840. The test “difference DV ≤ -0.020 dB/s - thyroid cancer’’ was characterized by sensitivity of 66.7%, specificity of 95.1%, positive predictive value of 94.3%, negative predictive value of 70.0%, and AUC of 0.842. Diagnostic tests for characterization of different morphological types of thyroid nodules in quantitative contrast-enhanced ultrasound were not found.

ультразвуковое исследование с контрастным усилением (КУУЗИ), количественный анализ КУУЗИ, Соновью, кривая “время-интенсивность”, рак щитовидной железы, contrast-enhanced ultrasound (CEUS), quantitative CEUS, SonoVue, time-intensity curve, thyroid cancer

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