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Thứ Sáu, 24 tháng 1, 2014

THYROID DISORDERS on JUM 2-2014



Selected Abstracts
1.    Abstract 1
2.    Original Research:
o    Ji-Zhen Zhang and
o    Bing Hu
Sonographic Features of Thyroid Follicular Carcinoma in Comparison With Thyroid Follicular Adenoma JUM February 2014 33:221-227; doi:10.7863/ultra.33.2.221
o    Abstract
o    Full Article
o    PDF
3.    Abstract 2
4.    Original Research:
o    Chang Yoon Lee,
o    Soo Jin Kim,
o    Kyung Ran Ko,
o    Ki-Wook Chung,
o    and Joo-Hyuk Lee
Predictive Factors for Extrathyroidal Extension of Papillary Thyroid Carcinoma Based on Preoperative Sonography JUM February 2014 33:231-238; doi:10.7863/ultra.33.2.231
o    Abstract
o    Full Article
o    PDF
5.    Abstract 3
6.    Original Research:
o    Dong Wook Kim,
o    Tae Kwun Ha,
o    Ha Kyoung Park,
o    and Taewoo Kang
Sonographic Detection of Thyroid Pyramidal Lobes Before Thyroid Surgery: A Prospective Single-Center Study JUM February 2014 33:239-244; doi:10.7863/ultra.33.2.239
o    Abstract
o    Full Article
o    PDF
7.    Abstract 4
8.    Original Research:
o    U. Rajendra Acharya,
o    S. Vinitha Sree,
o    M. Muthu Rama Krishnan,
o    Filippo Molinari,
o    Witold ZieleŸnik,
o    Ricardo H. Bardales,
o    Agnieszka Witkowska,
o    and Jasjit S. Suri
Computer-Aided Diagnostic System for Detection of Hashimoto Thyroiditis on Ultrasound Images From a Polish Population JUM February 2014 33:245-253; doi:10.7863/ultra.33.2.245
o    Abstract
o    Full Article
o    PDF
9.    Abstract 5
10.  Original Research:
o    Huiping Zhang,
o    Qiusheng Shi,
o    Jiying Gu,
o    Luying Jiang,
o    Min Bai,
o    Long Liu,
o    Ying Wu,
o    and Lianfang Du
Combined Value of Virtual Touch Tissue Quantification and Conventional Sonographic Features for Differentiating Benign and Malignant Thyroid Nodules Smaller Than 10 mm JUM February 2014 33:257-264; doi:10.7863/ultra.33.2.257
o    Abstract
o    Full Article
o    PDF
1.    Abstract 1 of 5Original Research
Sonographic Features of Thyroid Follicular Carcinoma in Comparison With Thyroid Follicular Adenoma
Objectives—The purpose of this study was to determine the sonographic features of thyroid follicular carcinoma in comparison with thyroid follicular adenoma.
Methods—This retrospective study included 36 pathologically proven follicular carcinomas (5 widely invasive and 31 minimally invasive) and 52 follicular adenomas in 88 patients who underwent thyroid surgery. We analyzed the sonographic features of each tumor, including maximum diameter, peripheral halo, echogenicity, echo texture, calcifications, and nodularity. The frequencies of the sonographic features were compared by χ2 and Fisher exact tests between follicular adenomas and carcinomas. The relative risk of malignancy was evaluated by logistic regression analysis.
Results—Predominantly solid contents, hypoechoic echogenicity, a heterogeneous echo texture, the presence of calcifications, and an absent or irregular thick halo were associated with follicular carcinoma (P < .05). Logistic regression analysis demonstrated that predominantly solid contents, a heterogeneous echo texture, and the presence of calcifications were associated with significant increases in the relative risk of follicular carcinoma (odds ratios, 9.4, 24.9, and 25.6, respectively; P < .01).
Conclusions—Sonography could provide useful information for differentiating follicular carcinoma from follicular adenoma.
o    Received April 1, 2013.
o    Revision received May 14, 2013.
o    Accepted June 24, 2013.
o    © 2014 by the American Institute of Ultrasound in Medicine
2.    Abstract 2 of 5Original Research
Predictive Factors for Extrathyroidal Extension of Papillary Thyroid Carcinoma Based on Preoperative Sonography
Objectives—The purpose of this study was to evaluate the diagnostic performance and predictive factors of extrathyroidal extension of papillary thyroid carcinoma based on preoperative sonography.
Methods—Preoperative sonography was performed for 568 patients who underwent surgery for papillary thyroid cancer between May 2009 and December 2010. Patients’ T stages based on preoperative sonography were compared with their T stages based on pathologic examination, and we statistically analyzed the discriminatory performance of sonography. Among the 568 patients enrolled in this study, we selected 320 patients in whom extrathyroidal extension was suspected on sonography. We analyzed several predictive factors for extrathyroidal extension.
Results—Two hundred seventy-five of the 568 patients were proven to have pathologic extrathyroidal extension of papillary thyroid cancer after surgery (75.9% diagnostic accuracy, 83.3% sensitivity, 68.9% specificity, 71.6% positive predictive value, and 81.5% negative predictive value). Of 320 patients with sonographically suspected extrathyroidal extension, a larger lesion size (P < .001) and a higher lymph node stage on sonography (P = .004) were the best predictors of extrathyroidal extension among the features that we measured. There were no significant differences in terms of the lesion site or thyroid parenchymal background echogenicity. Thyroid capsular protrusion had a higher predictive value than the abutting ratio (P = .001). However, increasing the abutting ratio enabled the prediction of extrathyroidal extension on sonography (P = .009).
Conclusions—Preoperative sonography is a helpful tool for predicting pathologic extrathyroidal extension of papillary thyroid cancer. In particular, clinicians should focus on the lesion size, nodal stage, and abutment or capsular protrusion of the lesion while performing sonography because these are the most useful predictive factors for extrathyroidal extension.
o    Revision received April 3, 2013.
o    Revision received May 10, 2013.
o    Accepted June 10, 2013.
o    © 2014 by the American Institute of Ultrasound in Medicine
3.    Abstract 3 of 5Original Research
Sonographic Detection of Thyroid Pyramidal Lobes Before Thyroid Surgery
A Prospective Single-Center Study
Objectives—This study aimed to assess the rate of preoperative sonographic detection of thyroid pyramidal lobes with subsequent surgical findings as the reference standard.
Methods—From January 2013 to March 2013, a single radiologist prospectively performed thyroid sonography to detect thyroid pyramidal lobes in consecutive patients who were scheduled for thyroid surgery on the same day. The location, anteroposterior and transverse diameters, length, and location of the upper end of each thyroid pyramidal lobe and its separation or contiguity with the main thyroid gland were investigated by thyroid sonography and surgery.
Results—The types of thyroid surgery included total thyroidectomy (n = 85), subtotal thyroidectomy (n = 4), and hemithyroidectomy (n = 43). The surgical incidence of thyroid pyramidal lobes was 59.8% (79 of 132), and the sensitivity, specificity, positive and negative predictive values, and accuracy of sonography for detection of thyroid pyramidal lobes were 81.0%, 79.2%, 85.3%, 73.7%, and 80.3%, respectively. The mean values for the anteroposterior diameter, transverse diameter, and length of the 79 thyroid pyramidal lobes at surgery were 2.2, 6.2, and 26.5 mm, respectively, but these measurements did not show statistically significant correlations with the sonographic detection rate of thyroid pyramidal lobes.
Conclusions—Our study indicates that thyroid sonography may be helpful for identifying the presence and location of thyroid pyramidal lobes.
o    Received May 2, 2013.
o    Revision received May 20, 2013.
o    Accepted June 1, 2013.
o    © 2014 by the American Institute of Ultrasound in Medicine
4.    Abstract 4 of 5Original Research
Computer-Aided Diagnostic System for Detection of Hashimoto Thyroiditis on Ultrasound Images From a Polish Population
Objectives—Computer-aided diagnostic (CAD) techniques aid physicians in better diagnosis of diseases by extracting objective and accurate diagnostic information from medical data. Hashimoto thyroiditis is the most common type of inflammation of the thyroid gland. The inflammation changes the structure of the thyroid tissue, and these changes are reflected as echogenic changes on ultrasound images. In this work, we propose a novel CAD system (a class of systems called ThyroScan) that extracts textural features from a thyroid sonogram and uses them to aid in the detection of Hashimoto thyroiditis.
Methods—In this paradigm, we extracted grayscale features based on stationary wavelet transform from 232 normal and 294 Hashimoto thyroiditis–affected thyroid ultrasound images obtained from a Polish population. Significant features were selected using a Student t test. The resulting feature vectors were used to build and evaluate the following 4 classifiers using a 10-fold stratified cross-validation technique: support vector machine, decision tree, fuzzy classifier, and K-nearest neighbor.
Results—Using 7 significant features that characterized the textural changes in the images, the fuzzy classifier had the highest classification accuracy of 84.6%, sensitivity of 82.8%, specificity of 87.0%, and a positive predictive value of 88.9%.
Conclusions—The proposed ThyroScan CAD system uses novel features to noninvasively detect the presence of Hashimoto thyroiditis on ultrasound images. Compared to manual interpretations of ultrasound images, the CAD system offers a more objective interpretation of the nature of the thyroid. The preliminary results presented in this work indicate the possibility of using such a CAD system in a clinical setting after evaluating it with larger databases in multicenter clinical trials.
o    Received February 13, 2013.
o    Revision received April 15, 2013.
o    Accepted June 3, 2013.
o    © 2014 by the American Institute of Ultrasound in Medicine
5.    Abstract 5 of 5Original Research
Combined Value of Virtual Touch Tissue Quantification and Conventional Sonographic Features for Differentiating Benign and Malignant Thyroid Nodules Smaller Than 10 mm
Objectives—This study aimed to investigate the value of sonographic features including Virtual Touch tissue quantification (VTQ; Siemens Medical Solutions, Mountain View, CA) for differentiating benign and malignant thyroid nodules smaller than 10 mm.
Methods—Seventy-one thyroid nodules smaller than 10 mm with pathologic diagnoses were included in this study. The conventional sonographic features and quantitative elasticity features (VTQ) were observed and compared between benign and malignant nodules.
Results—There were 39 benign and 32 malignant nodules according to histopathologic examination. When compared with benign nodules, malignant nodules were more frequently taller than wide, poorly defined, and markedly hypoechoic (P < .05). Color Doppler sonographic features were not significantly different between benign and malignant nodules. The VTQ value for malignant nodules (mean ± SD 3.260 ± 0.725 m/s) was significantly higher than that of benign ones (2.108 ± 0.455 m/s; P < .001). The cutoff point for the differential diagnosis was 2.910 m/s, with sensitivity, specificity, a positive predictive value, a negative predictive value, and diagnostic accuracy of 71.9%, 100%, 100%, 81.2%, and 87.3% respectively. Logistic regression analysis showed that a taller-than-wide shape, a poorly defined boundary, marked hypoechogenicity, and a VTQ value greater than 2.910 m/s were independent risk factors for malignancy, with odds ratios of 69.366, 41.864, 5.945, and 64.991. The combination of VTQ with a taller-than-wide shape had the highest sensitivity and specificity of 90.6% and 97.4%.
Conclusions—The shape, margin, echogenicity, and VTQ value are useful sonographic criteria for differentiating benign and malignant thyroid nodules smaller than 10 mm. When VTQ was combined with B-mode sonographic features, the sensitivity was improved significantly.
o    Received April 29, 2013.
o    Revision received May 22, 2013.
o    Accepted June 26, 2013.
o    © 2014 by the American Institute of Ultrasound in Medicine

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