Ultrasound microflow patterns help in distinguishing malignant from benign thyroid nodules
Abstract Background Vascular features are not commonly used to evaluate thyroid nodules by conventional ultrasound due to the low sensitivity. Superb Microvascular Imaging (SMI) is a new ultrasonic Doppler technology that specializes in depicting microvessels and low-speed flow. The objective of thi...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2024-01-01
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| Series: | Cancer Imaging |
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| Online Access: | https://doi.org/10.1186/s40644-024-00663-1 |
| _version_ | 1827329024087556096 |
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| author | Wanying Li Luying Gao Yiyan Du Ying Wang Xiao Yang Hongyan Wang Jianchu Li |
| author_facet | Wanying Li Luying Gao Yiyan Du Ying Wang Xiao Yang Hongyan Wang Jianchu Li |
| author_sort | Wanying Li |
| collection | DOAJ |
| description | Abstract Background Vascular features are not commonly used to evaluate thyroid nodules by conventional ultrasound due to the low sensitivity. Superb Microvascular Imaging (SMI) is a new ultrasonic Doppler technology that specializes in depicting microvessels and low-speed flow. The objective of this study was to explore the value of microflow features on SMI in differentiating malignant from benign thyroid nodules. Methods One hundred and seventy-seven adult patients with thyroid nodules in our center from October 2021 to June 2022 with available histopathological results were recruited, including 125 malignant nodules and 123 benign nodules. Preoperative ultrasound was performed using greyscale, Color Doppler Flow Imaging (CDFI), monochrome SMI (mSMI) and color SMI (cSMI). Vascular features such as flow richness, microflow distribution and microflow patterns of malignant thyroid nodules were compared with those of benign nodules. Results Penetrating vessel ≥ 1 (82.4% in the malignant group vs. 30.9% in the benign group, P < 0.001), the crab claw-like pattern (64.0% vs. 10.6%, P < 0.001) and the root hair-like pattern (8.0% vs. 2.4%, P = 0.049) were common in malignant thyroid nodules, among which the crab claw-like pattern was an independent risk factor for malignant thyroid nodules. The wheel-like pattern (1.6% in the malignant group vs. 33.3% in the benign group, P < 0.001) and the arborescent pattern (0 vs. 19.5%, P < 0.001) were more likely to appear in benign nodules. The diagnostic specificities of the crab claw-like pattern and the root hair-like pattern for malignant thyroid nodules were 0.894, 0.976, and the positive predictive values were 0.860, 0.769. The diagnostic specificities of the wheel-like pattern and the arborescent pattern for benign thyroid nodules were 0.984, 1.000, and the positive predictive values were 0.953, 1.000. Conclusions The crab claw-like pattern and the root hair-like pattern were microflow characteristics of malignant thyroid nodules. The wheel-like pattern and the arborescent pattern could help exclude the diagnosis of thyroid cancer. |
| first_indexed | 2024-03-07T15:26:52Z |
| format | Article |
| id | doaj.art-82b13d2107124d238e9eb67472f57ac1 |
| institution | Directory Open Access Journal |
| issn | 1470-7330 |
| language | English |
| last_indexed | 2024-03-07T15:26:52Z |
| publishDate | 2024-01-01 |
| publisher | BMC |
| record_format | Article |
| series | Cancer Imaging |
| spelling | doaj.art-82b13d2107124d238e9eb67472f57ac12024-03-05T16:41:03ZengBMCCancer Imaging1470-73302024-01-012411910.1186/s40644-024-00663-1Ultrasound microflow patterns help in distinguishing malignant from benign thyroid nodulesWanying Li0Luying Gao1Yiyan Du2Ying Wang3Xiao Yang4Hongyan Wang5Jianchu Li6Department of Ultrasound, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical CollegeDepartment of Ultrasound, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical CollegeDepartment of Ultrasound, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical CollegeDepartment of Ultrasound, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical CollegeDepartment of Ultrasound, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical CollegeDepartment of Ultrasound, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical CollegeDepartment of Ultrasound, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical CollegeAbstract Background Vascular features are not commonly used to evaluate thyroid nodules by conventional ultrasound due to the low sensitivity. Superb Microvascular Imaging (SMI) is a new ultrasonic Doppler technology that specializes in depicting microvessels and low-speed flow. The objective of this study was to explore the value of microflow features on SMI in differentiating malignant from benign thyroid nodules. Methods One hundred and seventy-seven adult patients with thyroid nodules in our center from October 2021 to June 2022 with available histopathological results were recruited, including 125 malignant nodules and 123 benign nodules. Preoperative ultrasound was performed using greyscale, Color Doppler Flow Imaging (CDFI), monochrome SMI (mSMI) and color SMI (cSMI). Vascular features such as flow richness, microflow distribution and microflow patterns of malignant thyroid nodules were compared with those of benign nodules. Results Penetrating vessel ≥ 1 (82.4% in the malignant group vs. 30.9% in the benign group, P < 0.001), the crab claw-like pattern (64.0% vs. 10.6%, P < 0.001) and the root hair-like pattern (8.0% vs. 2.4%, P = 0.049) were common in malignant thyroid nodules, among which the crab claw-like pattern was an independent risk factor for malignant thyroid nodules. The wheel-like pattern (1.6% in the malignant group vs. 33.3% in the benign group, P < 0.001) and the arborescent pattern (0 vs. 19.5%, P < 0.001) were more likely to appear in benign nodules. The diagnostic specificities of the crab claw-like pattern and the root hair-like pattern for malignant thyroid nodules were 0.894, 0.976, and the positive predictive values were 0.860, 0.769. The diagnostic specificities of the wheel-like pattern and the arborescent pattern for benign thyroid nodules were 0.984, 1.000, and the positive predictive values were 0.953, 1.000. Conclusions The crab claw-like pattern and the root hair-like pattern were microflow characteristics of malignant thyroid nodules. The wheel-like pattern and the arborescent pattern could help exclude the diagnosis of thyroid cancer.https://doi.org/10.1186/s40644-024-00663-1Thyroid noduleUltrasoundSuperb microvascular imagingMicroflow characteristics |
| spellingShingle | Wanying Li Luying Gao Yiyan Du Ying Wang Xiao Yang Hongyan Wang Jianchu Li Ultrasound microflow patterns help in distinguishing malignant from benign thyroid nodules Cancer Imaging Thyroid nodule Ultrasound Superb microvascular imaging Microflow characteristics |
| title | Ultrasound microflow patterns help in distinguishing malignant from benign thyroid nodules |
| title_full | Ultrasound microflow patterns help in distinguishing malignant from benign thyroid nodules |
| title_fullStr | Ultrasound microflow patterns help in distinguishing malignant from benign thyroid nodules |
| title_full_unstemmed | Ultrasound microflow patterns help in distinguishing malignant from benign thyroid nodules |
| title_short | Ultrasound microflow patterns help in distinguishing malignant from benign thyroid nodules |
| title_sort | ultrasound microflow patterns help in distinguishing malignant from benign thyroid nodules |
| topic | Thyroid nodule Ultrasound Superb microvascular imaging Microflow characteristics |
| url | https://doi.org/10.1186/s40644-024-00663-1 |
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