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Cancer Imaging

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Open Access 01-12-2024 | Thyroid Cancer | Research article

Ultrasound microflow patterns help in distinguishing malignant from benign thyroid nodules

Authors: Wanying Li, Luying Gao, Yiyan Du, Ying Wang, Xiao Yang, Hongyan Wang, Jianchu Li

Published in: Cancer Imaging | Issue 1/2024

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.

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Title: Ultrasound microflow patterns help in distinguishing malignant from benign thyroid nodules
Authors: Wanying Li
Luying Gao
Yiyan Du
Ying Wang
Xiao Yang
Hongyan Wang
Jianchu Li
Publication date: 01-12-2024
Publisher: BioMed Central
Keywords: Thyroid Cancer
Thyroid Cancer
Thyroid Cancer
Published in: Cancer Imaging / Issue 1/2024
Electronic ISSN: 1470-7330
DOI: https://doi.org/10.1186/s40644-024-00663-1

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