ULTRASOUND and THYROID CANCER in LOW-RISK GROUP

Researchers from the University of California, San Francisco, undertook a study to quantify the risk of thyroid cancer associated with thyroid nodules, based on ultrasound imaging characteristics.
The retrospective, case-controlled study assessed 8,806 patients who underwent 11,618 thyroid ultrasound examinations from January 2000 through March 2005. A total of 105 patients were subsequently diagnosed with thyroid cancer.
It was found that thyroid nodules were common among patients who had thyroid cancer (96.9 percent) and also among those who did not (56.4 percent).
The researchers noted that there were three ultrasound nodule characteristics that were only associated with the risk of thyroid cancer:
· Microcalcifications
· Size greater than 2 cm
· Entirely solid composition
It was determined that most cases of thyroid cancer could be detected if biopsies were performed based on using one characteristic as indication for the procedure. Two characteristics as basis for biopsy would bring the sensitivity and false-positive rates lower with a higher positive likelihood ratio.
These results showed the rate of unnecessary biopsies could be reduced by 90 percent while maintaining a low risk of cancer if there were a more stringent approach for performing biopsies, researchers said.
"Adoption of uniform standards for the interpretation of thyroid sonograms would be a first step toward standardizing the diagnosis and treatment of thyroid cancer and limiting unnecessary diagnostic testing and treatment," the study concluded.

- See more at: http://www.diagnosticimaging.com/ultrasound/ultrasound-images-identify-thyroid-cancer-low-risk-group?

CHEST WALL INVASION by LUNG TUMORS: US versus CT

ABSTRACT

Objectives—To analyze qualitative and quantitative parameters of lung tumors by color Doppler sonography, determine the role of color Doppler sonography in predicting chest wall invasion by lung tumors using spectral waveform analysis, and compare color Doppler sonography and computed tomography (CT) for predicting chest wall invasion by lung tumors.

Methods—Between March and September 2007, 55 patients with pleuropulmonary lesions on chest radiography were assessed by grayscale and color Doppler sonography for chest wall invasion. Four patients were excluded from the study because of poor acoustic windows. Quantitative and qualitative sonographic examinations of the lesions were performed using grayscale and color Doppler imaging. The correlation between the color Doppler and CT findings was determined, and the final outcomes were

correlated with the histopathologic findings.

Results—Of a total of 51 lesions, 32 were malignant. Vascularity was present on color Doppler sonography in 28 lesions, and chest wall invasion was documented in 22 cases. Computed tomography was performed in 24 of 28 evaluable malignant lesions, and the findings were correlated with the color Doppler findings for chest wall invasion. Of the 24 patients who underwent CT, 19 showed chest wall invasion. The correlation between the color Doppler and CT findings revealed that color Doppler sonography had sensitivity of 95.6% and specificity of 100% for assessing chest wall invasion, whereas CT had sensitivity of 85.7% and specificity of 66.7%. 

Conclusions—Combined qualitative and quantitative color Doppler sonography can predict chest wall invasion by lung tumors with better sensitivity and specificity than CT. Although surgery is the reference standard, color Doppler sonography is a readily available, affordable, and noninvasive in vivo diagnostic imaging modality that is complementary to CT and magnetic resonance imaging for lung cancer staging.