ARFI Imaging of Thyroid Nodules

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ARFI measurements of 85 thyroid nodules in comparison to FNAC results

Text of ARFI Imaging of Thyroid Nodules

  • 1.HUNG THIEN NGUYEN, CUONG TUAN NGUYEN, XUAN THANH THI PHAM, HAI THANHPHANMEDIC MEDICAL CENTER, HCMC, VIETNAM

2. Acousticradiation force impulse (ARFI)-imaging is a new technology of elastography of ultrasound enabling quantitative measurement of tissue stiffness. Theaim of the present study was to evaluate the feasibility of ARFI-measurements in the thyroid nodule. 3. All patients underwent conventionalultrasound, ARFI-imaging and cytologicalassessment. ARFI-imaging (VTI and VTQ technologies) andeSie Touch technology were performed with 9L4probe, using Siemens (ACUSON S2000) B-mode-ARFI combination transducer. 4. 85 nodules were available for analysis. 67 nodules were benign on cytology, 13nodules were malignant (papillary carcinoma), and 5 follicular lesions. 5. Themedian velocity of ARFI-imaging in benign was of 2.06 m/s, andmalignant thyroid nodules, of 3.00 m/s, respectively. 6. Plot of 177 ARFI velocity measurements of 85 thyroid nodules 7. eSieTouch= malignant: red code (hard)homogenous or not VTI= malignant: dark color (hard) andbigger size than B-mode image VTI with dark color helps characterizingmalignant nodule, from follicular lesionsand dense colloidal cysts which havebright color on VTI. 8. eSie Touch of a papillary carcinoma, black (hard) 9. VTI of a papillary carcinoma, black (hard) and bigger size (R. panel) than B-mode image (L. panel) 10. eSie Touch of papillary carcinoma, inhomogenous black 11. VTQ of a papilary carcinoma with ARFI velocity in out of range 12. eSie Touch of a papillary carcinoma, color code (red= hard, purple= soft, yellow= between hard and soft). FNAC should perform at red region. 13. FNAC of a papillary carcinoma 14. FNAC of a papillary carcinoma 15. VTQ of a follicular lesion with ARFI velocity of 2.99 m/s (>2.3 m/s) 16. 3 follicular lesions on Doppler and B-mode ultrasound 17. VTI of a follicular lesion (R. panel) with dark color (hard) and bigger size in comparison to B-mode image (L. panel) 18. FNAC of a follicular lesion 19. FNAC of a follicular lesion 20. FNAC of a colloidal cyst 21. Aspecificity of ARFI-imaging of 95% couldbe achieved using a cut-off of 3.1 m/s(area under ROC curve is 0.778). A sensibility of ARFI-imaging of 86.49%and specificity of 59.29% could beachieved using a cut-off of 2.3 m/s (areaunder ROC curve is 0.778). 22. Area under the ROC curve: 0.778. 23. DISCUSSIONS1/ Specificity important than sensibility2/ The higher of ARFI velocity the harder ofthyroid nodule3/ Overlapping the ARFI velocities of benign andmalignant nodules: combining with VTI, eSieTouch to charaterize lesion4/ Inhomogenous structure of malignant thyroidnodules: more site measurements of VTQ basedon VTI and eSie Touch and biopsy 24. ARFI can be performed in thyroid nodule with reliable results. Notonly base on VTQ but should refer VTI and eSie Touch technologies. ARFImight be the reference criteria for differentiation of benign and malignant thyroid nodules.