Skip to main content
Top
Published in: European Radiology 10/2006

01-10-2006 | Head and Neck

Qualitative and quantitative evaluation of solitary thyroid nodules with contrast-enhanced ultrasound: initial results

Authors: Tommaso Vincenzo Bartolotta, Massimo Midiri, Massimo Galia, Giuseppe Runza, Marco Attard, Giovanni Savoia, Roberto Lagalla, Adelfio Elio Cardinale

Published in: European Radiology | Issue 10/2006

Login to get access

Abstract

To assess the feasibility of contrast-enhanced ultrasound (CEUS) of the thyroid gland and to evaluate the potential of this method for characterising solitary thyroid nodules.18 patients affected by solitary thyroid nodules (size range: 0.6 to 3.6 cm; mean: 1.8 cm) confirmed by surgery (nine papillary carcinomas, four follicular carcinomas, three hyperplasias, one follicular adenoma and one Plummer’s adenoma) underwent pulse inversion US at low M.I. (0.06 to 0.08) after i.v. injection of a 2.4-mL bolus of SonoVue. Baseline echogenicity and the dynamic enhancement pattern of each nodule, in comparison with adjacent thyroid parenchyma, were assessed. Signal intensity values on grey-scale images were also calculated at baseline, 30 s, 60 s and 120 s after SonoVue administration. Following administration of SonoVue, malignant nodules showed absent (4 out of 13), faint dotted (4 out of 13) and diffuse (5 out of 13) contrast enhancement, in this last case inhomogeneous (4 out of 5 cases) or homogeneous (1 out of 5). Benign nodules showed diffuse contrast enhancement, both homogeneous (3 out of 5) and heterogeneous (2 out of 5). Quantitative data have confirmed subjective findings, but CEUS never modified precontrast analysis. CEUS of thyroid gland is a feasible technique, but overlapping findings seem to limit the potential of this technique in the characterization of thyroid nodules.
Literature
1.
go back to reference Solbiati L, Osti V, Cova L, Tonolini M (2001) Ultrasound of thyroid, parathyroid glands and neck limph nodes. Eur Radiol 11:2411–2424PubMedCrossRef Solbiati L, Osti V, Cova L, Tonolini M (2001) Ultrasound of thyroid, parathyroid glands and neck limph nodes. Eur Radiol 11:2411–2424PubMedCrossRef
2.
go back to reference Brander A, Viikinkoski P, Nickels J, Kivisaari L (1991) Thyroid gland: US screening in a random adult population. Radiology 181:683–687PubMed Brander A, Viikinkoski P, Nickels J, Kivisaari L (1991) Thyroid gland: US screening in a random adult population. Radiology 181:683–687PubMed
3.
go back to reference Ezzat S, Sarti DA, Cain DR, Braunstein GD (1994) Thyroid incidentalomas. Prevalence by palpation and ultrasonography. Arch Intern Med 154:1838–1840PubMedCrossRef Ezzat S, Sarti DA, Cain DR, Braunstein GD (1994) Thyroid incidentalomas. Prevalence by palpation and ultrasonography. Arch Intern Med 154:1838–1840PubMedCrossRef
4.
go back to reference Wiest PW, Hartshorne MF, Inskip PD, Crooks LA, Vela BS, Telepak RJ, Williamson MR, Blumhardt R, Bauman JM, Tekkel M (1998) Thyroid palpation versus high-resolution thyroid ultrasonography in the detection of nodules. J Ultrasound Med 17:487–496PubMed Wiest PW, Hartshorne MF, Inskip PD, Crooks LA, Vela BS, Telepak RJ, Williamson MR, Blumhardt R, Bauman JM, Tekkel M (1998) Thyroid palpation versus high-resolution thyroid ultrasonography in the detection of nodules. J Ultrasound Med 17:487–496PubMed
5.
go back to reference Tan GH, Gharib H, Reading CC (1995) Solitary thyroid nodule. Comparison between palpation and ultrasonography. Arch Intern Med 155:2418–2423PubMedCrossRef Tan GH, Gharib H, Reading CC (1995) Solitary thyroid nodule. Comparison between palpation and ultrasonography. Arch Intern Med 155:2418–2423PubMedCrossRef
6.
go back to reference Ross DS (2002) Nonpalpable thyroid nodules-managing an epidemic. J Clin Endocrinol Metab 87:1938–1940PubMedCrossRef Ross DS (2002) Nonpalpable thyroid nodules-managing an epidemic. J Clin Endocrinol Metab 87:1938–1940PubMedCrossRef
7.
go back to reference Wang C, Crapo LM (1997) The epidemiology of thyroid disease and implications for screening. Endocrinol Metab Clin North Am 26:189–218PubMedCrossRef Wang C, Crapo LM (1997) The epidemiology of thyroid disease and implications for screening. Endocrinol Metab Clin North Am 26:189–218PubMedCrossRef
8.
go back to reference Martinez-Tello FJ, Martinez-Cabruja R, Fernandez-Martin J, Lasso-Oria C, Ballestin-Carcavilla C (1993) Occult carcinoma of the thyroid. A systematic autopsy study from Spain of two series performed with two different methods. Cancer 71:4022–4029PubMedCrossRef Martinez-Tello FJ, Martinez-Cabruja R, Fernandez-Martin J, Lasso-Oria C, Ballestin-Carcavilla C (1993) Occult carcinoma of the thyroid. A systematic autopsy study from Spain of two series performed with two different methods. Cancer 71:4022–4029PubMedCrossRef
9.
go back to reference Burns PN, Wilson SR, Simpson DH (2000) Pulse inversion imaging of liver blood flow: improved method for characterizing focal masses with microbubble contrast. Invest Radiol 35:58–71PubMedCrossRef Burns PN, Wilson SR, Simpson DH (2000) Pulse inversion imaging of liver blood flow: improved method for characterizing focal masses with microbubble contrast. Invest Radiol 35:58–71PubMedCrossRef
10.
go back to reference Argalia G, De Bernardis S, Mariani D et al (2002) Ultrasonographic contrast agent: evaluation of time intensity curves in the characterisation of solitary thyroid nodules. Radiol Med 103:407–413PubMed Argalia G, De Bernardis S, Mariani D et al (2002) Ultrasonographic contrast agent: evaluation of time intensity curves in the characterisation of solitary thyroid nodules. Radiol Med 103:407–413PubMed
11.
go back to reference Spiezia S, Farina R, Cerbone G et al (2001) Analysis of color Doppler signal intensity variation after levovist injection: a new approach to the diagnosis of thyroid nodules. J Ultrasound Med 20:223–231PubMed Spiezia S, Farina R, Cerbone G et al (2001) Analysis of color Doppler signal intensity variation after levovist injection: a new approach to the diagnosis of thyroid nodules. J Ultrasound Med 20:223–231PubMed
12.
go back to reference Schneider M, Arditi M, Barrau M et al (1995) BRI: a new ultrasonographic contrast agent based on sulphur hexafluoride-filled microbubbes. Invest Radiol 30:451–457PubMedCrossRef Schneider M, Arditi M, Barrau M et al (1995) BRI: a new ultrasonographic contrast agent based on sulphur hexafluoride-filled microbubbes. Invest Radiol 30:451–457PubMedCrossRef
13.
go back to reference Quaia E, Calliada F, Bertolotto M et al (2004) Characterization of focal liver lesions with contrast-specific US modes and a sulfur hexafluoride-filled microbubble contrast agent: diagnostic performance and confidence. Radiology 232:420–430PubMedCrossRef Quaia E, Calliada F, Bertolotto M et al (2004) Characterization of focal liver lesions with contrast-specific US modes and a sulfur hexafluoride-filled microbubble contrast agent: diagnostic performance and confidence. Radiology 232:420–430PubMedCrossRef
14.
go back to reference Bartolotta TV, Midiri M, Quaia E et al (2005) Liver haemangiomas undetermined at grey-scale ultrasound: contrast-enhancement patterns with SonoVue and pulse-inversion US. Eur Radiol 15:685–693PubMedCrossRef Bartolotta TV, Midiri M, Quaia E et al (2005) Liver haemangiomas undetermined at grey-scale ultrasound: contrast-enhancement patterns with SonoVue and pulse-inversion US. Eur Radiol 15:685–693PubMedCrossRef
15.
go back to reference Bartolotta TV, Midiri M, Quaia E et al (2005) Benign focal liver lesions: spectrum of findings on SonoVue-enhanced pulse-inversion ultrasonography. Eur Radiol 15:1643–1649PubMedCrossRef Bartolotta TV, Midiri M, Quaia E et al (2005) Benign focal liver lesions: spectrum of findings on SonoVue-enhanced pulse-inversion ultrasonography. Eur Radiol 15:1643–1649PubMedCrossRef
17.
go back to reference Leen E, Angerson WJ, Yarmenitis S et al (2002) Multi-centre clinical study evaluating the efficacy of SonoVue (BR1), a new contrast agent in Doppler investigation of focal hepatic lesions. Eur J Radiol 41:200–206PubMedCrossRef Leen E, Angerson WJ, Yarmenitis S et al (2002) Multi-centre clinical study evaluating the efficacy of SonoVue (BR1), a new contrast agent in Doppler investigation of focal hepatic lesions. Eur J Radiol 41:200–206PubMedCrossRef
18.
go back to reference Solbiati L, Livraghi T, Ballarati E, Ierace T, Crespi L (1996) Thyroid gland. In: Solbiati L, Rizzatto G, Charboneau JW (eds) Ultrasound of superficial structures. Churchill-Livingstone, Edinburgh, pp 48–85 Solbiati L, Livraghi T, Ballarati E, Ierace T, Crespi L (1996) Thyroid gland. In: Solbiati L, Rizzatto G, Charboneau JW (eds) Ultrasound of superficial structures. Churchill-Livingstone, Edinburgh, pp 48–85
19.
go back to reference Kim EK, Park CS, Chung WY et al (2002) New sonographic criteria for recommending fine-needle aspiration biopsy of nonpalpable solid nodules of the thyroid. Am J Roentgenol 178:687–691 Kim EK, Park CS, Chung WY et al (2002) New sonographic criteria for recommending fine-needle aspiration biopsy of nonpalpable solid nodules of the thyroid. Am J Roentgenol 178:687–691
20.
go back to reference Lagalla R, Caruso G, Novara V, Cardinale AE (1993) Flowmetric analysis of thyroid diseases: hypothesis on integration with qualitative color-Doppler study. Radiol Med 85:606–610PubMed Lagalla R, Caruso G, Novara V, Cardinale AE (1993) Flowmetric analysis of thyroid diseases: hypothesis on integration with qualitative color-Doppler study. Radiol Med 85:606–610PubMed
21.
go back to reference Papini E, Guglielmi R, Bianchini A et al (2002) Risk of malignancy in nonpalpable thyroid nodules: predictive value of ultrasound and color-Doppler features. J Clin Endocrinol Metab 87:1941–1946PubMedCrossRef Papini E, Guglielmi R, Bianchini A et al (2002) Risk of malignancy in nonpalpable thyroid nodules: predictive value of ultrasound and color-Doppler features. J Clin Endocrinol Metab 87:1941–1946PubMedCrossRef
22.
go back to reference Bertolotto M, Dalla Palma L, Quaia E, Locatelli M (2000) Characterization of unifocal liver lesions with pulse inversion harmonic imaging after Levovist injection: preliminary results. Eur Radiol 10:1369–1376PubMedCrossRef Bertolotto M, Dalla Palma L, Quaia E, Locatelli M (2000) Characterization of unifocal liver lesions with pulse inversion harmonic imaging after Levovist injection: preliminary results. Eur Radiol 10:1369–1376PubMedCrossRef
23.
go back to reference Bartolotta TV, Midiri M, Scialpi M, Sciarrino E, Galia M, Lagalla R (2004) Focal nodular hyperplasia in normal and fatty liver: a qualitative and quantitative evaluation with contrast-enhanced ultrasound. Eur Radiol 14:583–591PubMedCrossRef Bartolotta TV, Midiri M, Scialpi M, Sciarrino E, Galia M, Lagalla R (2004) Focal nodular hyperplasia in normal and fatty liver: a qualitative and quantitative evaluation with contrast-enhanced ultrasound. Eur Radiol 14:583–591PubMedCrossRef
24.
go back to reference Kuma K, Matsuzuka F, Yokozawa T, Miyauchi A, Sugawara M (1994) Fate of untreated benign thyroid nodules: results of long-term follow-up. World J Surg 18:495–498PubMedCrossRef Kuma K, Matsuzuka F, Yokozawa T, Miyauchi A, Sugawara M (1994) Fate of untreated benign thyroid nodules: results of long-term follow-up. World J Surg 18:495–498PubMedCrossRef
25.
go back to reference Marqusee E, Benson CB, Frates MC et al (2000) Usefulness of ultrasonography in the management of nodular thyroid disease. Ann Intern Med 133:696–700PubMed Marqusee E, Benson CB, Frates MC et al (2000) Usefulness of ultrasonography in the management of nodular thyroid disease. Ann Intern Med 133:696–700PubMed
26.
go back to reference Gritzmann N, Koischwitz D, Rettenbacher T (2000) Sonography of the thyroid and parathyroid glands. Radiol Clin North Am 38:1131–1145PubMedCrossRef Gritzmann N, Koischwitz D, Rettenbacher T (2000) Sonography of the thyroid and parathyroid glands. Radiol Clin North Am 38:1131–1145PubMedCrossRef
27.
go back to reference Solbiati L (1998) Thyroid gland. In: James EM (ed) Diagnostic ultrasound. Mosby, St Louis, pp 703–729 Solbiati L (1998) Thyroid gland. In: James EM (ed) Diagnostic ultrasound. Mosby, St Louis, pp 703–729
28.
go back to reference Kats JF, Kane RA, Reyes J, Clarke MP, Hill TC (1984) Thyroid nodules: sonographic-pathologic correlation. Radiology 151:741–745 Kats JF, Kane RA, Reyes J, Clarke MP, Hill TC (1984) Thyroid nodules: sonographic-pathologic correlation. Radiology 151:741–745
29.
go back to reference Rago T, Vitti P, Chiovato L et al (1998) Role of conventional ultrasonography and color flow-Doppler sonography in predicting malignancy in ‘cold’ thyroid nodules. Eur J Endocrinol 138:41–46PubMedCrossRef Rago T, Vitti P, Chiovato L et al (1998) Role of conventional ultrasonography and color flow-Doppler sonography in predicting malignancy in ‘cold’ thyroid nodules. Eur J Endocrinol 138:41–46PubMedCrossRef
30.
go back to reference Hagag P, Strauss S, Weiss M (1988) Role of ultrasound-guided fine-needle aspiration biopsy in evaluation of nonpalpable thyroid nodules. Thyroid 8:989–995CrossRef Hagag P, Strauss S, Weiss M (1988) Role of ultrasound-guided fine-needle aspiration biopsy in evaluation of nonpalpable thyroid nodules. Thyroid 8:989–995CrossRef
31.
32.
go back to reference Leen E (2001) The role of contrast-enhanced ultrasound in the detection of focal liver lesions. Eur Radiol 11(Suppl. 3):E27–E34PubMedCrossRef Leen E (2001) The role of contrast-enhanced ultrasound in the detection of focal liver lesions. Eur Radiol 11(Suppl. 3):E27–E34PubMedCrossRef
33.
go back to reference Lencioni R, Cioni D, Bartolozzi C (2002) Tissue harmonic and contrast-specific imaging: back to gray scale in ultrasound. Eur Radiol 12:151–165PubMedCrossRef Lencioni R, Cioni D, Bartolozzi C (2002) Tissue harmonic and contrast-specific imaging: back to gray scale in ultrasound. Eur Radiol 12:151–165PubMedCrossRef
34.
go back to reference Solbiati L, Tonolini M, Cova L, Goldberg N (2001) The role of contrast-enhanced ultrasound in the detection of focal liver lesions. Eur Radiol 11(Suppl. 3):E15–E26PubMedCrossRef Solbiati L, Tonolini M, Cova L, Goldberg N (2001) The role of contrast-enhanced ultrasound in the detection of focal liver lesions. Eur Radiol 11(Suppl. 3):E15–E26PubMedCrossRef
35.
go back to reference Albrecht T, Oldenburg A, Hohmann J et al (2003) Imaging of liver metastases with contrast-specific low-MI real-time ultrasound and SonoVue. Eur Radiol 13(Suppl 3):79–86CrossRef Albrecht T, Oldenburg A, Hohmann J et al (2003) Imaging of liver metastases with contrast-specific low-MI real-time ultrasound and SonoVue. Eur Radiol 13(Suppl 3):79–86CrossRef
36.
go back to reference Passe TJ, Bluemke DA, Siegelman SS (1997) Tumor angiogenesis: tutorial on implications for imaging. Radiology 203:593–600PubMed Passe TJ, Bluemke DA, Siegelman SS (1997) Tumor angiogenesis: tutorial on implications for imaging. Radiology 203:593–600PubMed
Metadata
Title
Qualitative and quantitative evaluation of solitary thyroid nodules with contrast-enhanced ultrasound: initial results
Authors
Tommaso Vincenzo Bartolotta
Massimo Midiri
Massimo Galia
Giuseppe Runza
Marco Attard
Giovanni Savoia
Roberto Lagalla
Adelfio Elio Cardinale
Publication date
01-10-2006
Publisher
Springer-Verlag
Published in
European Radiology / Issue 10/2006
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI
https://doi.org/10.1007/s00330-006-0229-y

Other articles of this Issue 10/2006

European Radiology 10/2006 Go to the issue

Book Reviews

Recent literature