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The clinical significance of ultrasound grayscale ratio in differentiating markedly hypoechoic and anechoic minimal thyroid nodules
Purpose: This study explored ultrasound grayscale ratios (USGRs) for differentiating markedly hypoechoic and anechoic minimal thyroid nodules. Materials and Methods: Longitudinal scan images of 193 markedly hypoechoic papillary thyroid microcarcinoma (PTMC) lesions from 184 patients were retrospecti...
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Published in: | Journal of cancer research and therapeutics 2018-01, Vol.14 (7), p.1567-1571 |
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description | Purpose: This study explored ultrasound grayscale ratios (USGRs) for differentiating markedly hypoechoic and anechoic minimal thyroid nodules.
Materials and Methods: Longitudinal scan images of 193 markedly hypoechoic papillary thyroid microcarcinoma (PTMC) lesions from 184 patients were retrospectively reviewed using RADinfo and compared with 123 anechoic micronodular goiters (MNGs) from 110 patients. Final diagnosis was validated by pathological examination; MNGs predominantly manifested with cyst formation. Grayscale values of PTMC, MNG, and normal surrounding tissues were obtained from grayscale histograms; USGRs (grayscale ratios of pathologic tissue to surrounding normal tissue) of PTMC and MNG were calculated. Optimal USGRs for differentiating PTMC and MNG were determined with receiver operating characteristic (ROC) curves.
Results: Among 193 PTMC and 123 MNG lesions, USGRs were 0.24-0.51 (mean ± standard deviation [SD]: 0.41 ± 0.07) and 0.01-0.38 (mean ± SD: 0.12 ± 0.08), respectively. The area under the ROC curve for distinguishing markedly hypoechoic PTMC and anechoic MNG was 0.992. As USGRs decreased, sensitivity decreased and specificity increased for MNG diagnosis. At a USGR of 0.26, the Youden index was high (0.933), corresponding to 94.3% sensitivity and 99% specificity for predicting anechoic MNG. At a USGR of 0.23, sensitivity and specificity for diagnosing anechoic MNG were 92.7% and 100%, respectively. In contrast, as USGR increased, sensitivity decreased and specificity increased for predicting PTMC. At a USGR of 0.38, sensitivity and specificity for diagnosing markedly hypoechoic PTMC were 68.4% and 100%, respectively.
Conclusions: USGRs could objectively quantize grayscale values of markedly hypoechoic and anechoic lesions, enabling accurate and quantitative determination of nodular properties. |
doi_str_mv | 10.4103/jcrt.JCRT_1031_17 |
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Materials and Methods: Longitudinal scan images of 193 markedly hypoechoic papillary thyroid microcarcinoma (PTMC) lesions from 184 patients were retrospectively reviewed using RADinfo and compared with 123 anechoic micronodular goiters (MNGs) from 110 patients. Final diagnosis was validated by pathological examination; MNGs predominantly manifested with cyst formation. Grayscale values of PTMC, MNG, and normal surrounding tissues were obtained from grayscale histograms; USGRs (grayscale ratios of pathologic tissue to surrounding normal tissue) of PTMC and MNG were calculated. Optimal USGRs for differentiating PTMC and MNG were determined with receiver operating characteristic (ROC) curves.
Results: Among 193 PTMC and 123 MNG lesions, USGRs were 0.24-0.51 (mean ± standard deviation [SD]: 0.41 ± 0.07) and 0.01-0.38 (mean ± SD: 0.12 ± 0.08), respectively. The area under the ROC curve for distinguishing markedly hypoechoic PTMC and anechoic MNG was 0.992. As USGRs decreased, sensitivity decreased and specificity increased for MNG diagnosis. At a USGR of 0.26, the Youden index was high (0.933), corresponding to 94.3% sensitivity and 99% specificity for predicting anechoic MNG. At a USGR of 0.23, sensitivity and specificity for diagnosing anechoic MNG were 92.7% and 100%, respectively. In contrast, as USGR increased, sensitivity decreased and specificity increased for predicting PTMC. At a USGR of 0.38, sensitivity and specificity for diagnosing markedly hypoechoic PTMC were 68.4% and 100%, respectively.
Conclusions: USGRs could objectively quantize grayscale values of markedly hypoechoic and anechoic lesions, enabling accurate and quantitative determination of nodular properties.</description><identifier>ISSN: 0973-1482</identifier><identifier>EISSN: 1998-4138</identifier><identifier>DOI: 10.4103/jcrt.JCRT_1031_17</identifier><identifier>PMID: 30589040</identifier><language>eng</language><publisher>India: Wolters Kluwer India Pvt. Ltd</publisher><subject>Adult ; Aged ; Biopsy ; Calcification ; Carcinoma, Papillary - diagnostic imaging ; Carcinoma, Papillary - pathology ; Clinical significance ; Female ; Humans ; Image Processing, Computer-Assisted ; Male ; Middle Aged ; Neoplasm Grading ; Reproducibility of Results ; ROC Curve ; Thyroid cancer ; Thyroid gland ; Thyroid Nodule - diagnostic imaging ; Thyroid Nodule - pathology ; Ultrasonic imaging ; Ultrasonography - methods</subject><ispartof>Journal of cancer research and therapeutics, 2018-01, Vol.14 (7), p.1567-1571</ispartof><rights>2018. This work is published under https://creativecommons.org/licenses/by-nc-sa/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c437l-7ca37e1cf8268d2d8611abe49e3eb808a26a9e08f744beac7b89c7852b4b3d063</citedby></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.proquest.com/docview/2160689185?pq-origsite=primo$$EHTML$$P50$$Gproquest$$Hfree_for_read</linktohtml><link.rule.ids>314,780,784,25753,27924,27925,37012,37013,44590</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/30589040$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Lei, Zhi-Kai</creatorcontrib><creatorcontrib>Li, Ming-Kui</creatorcontrib><creatorcontrib>Luo, Ding-Cun</creatorcontrib><creatorcontrib>Han, Zhi-Jiang</creatorcontrib><title>The clinical significance of ultrasound grayscale ratio in differentiating markedly hypoechoic and anechoic minimal thyroid nodules</title><title>Journal of cancer research and therapeutics</title><addtitle>J Cancer Res Ther</addtitle><description>Purpose: This study explored ultrasound grayscale ratios (USGRs) for differentiating markedly hypoechoic and anechoic minimal thyroid nodules.
Materials and Methods: Longitudinal scan images of 193 markedly hypoechoic papillary thyroid microcarcinoma (PTMC) lesions from 184 patients were retrospectively reviewed using RADinfo and compared with 123 anechoic micronodular goiters (MNGs) from 110 patients. Final diagnosis was validated by pathological examination; MNGs predominantly manifested with cyst formation. Grayscale values of PTMC, MNG, and normal surrounding tissues were obtained from grayscale histograms; USGRs (grayscale ratios of pathologic tissue to surrounding normal tissue) of PTMC and MNG were calculated. Optimal USGRs for differentiating PTMC and MNG were determined with receiver operating characteristic (ROC) curves.
Results: Among 193 PTMC and 123 MNG lesions, USGRs were 0.24-0.51 (mean ± standard deviation [SD]: 0.41 ± 0.07) and 0.01-0.38 (mean ± SD: 0.12 ± 0.08), respectively. The area under the ROC curve for distinguishing markedly hypoechoic PTMC and anechoic MNG was 0.992. As USGRs decreased, sensitivity decreased and specificity increased for MNG diagnosis. At a USGR of 0.26, the Youden index was high (0.933), corresponding to 94.3% sensitivity and 99% specificity for predicting anechoic MNG. At a USGR of 0.23, sensitivity and specificity for diagnosing anechoic MNG were 92.7% and 100%, respectively. In contrast, as USGR increased, sensitivity decreased and specificity increased for predicting PTMC. At a USGR of 0.38, sensitivity and specificity for diagnosing markedly hypoechoic PTMC were 68.4% and 100%, respectively.
Conclusions: USGRs could objectively quantize grayscale values of markedly hypoechoic and anechoic lesions, enabling accurate and quantitative determination of nodular properties.</description><subject>Adult</subject><subject>Aged</subject><subject>Biopsy</subject><subject>Calcification</subject><subject>Carcinoma, Papillary - diagnostic imaging</subject><subject>Carcinoma, Papillary - pathology</subject><subject>Clinical significance</subject><subject>Female</subject><subject>Humans</subject><subject>Image Processing, Computer-Assisted</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Neoplasm Grading</subject><subject>Reproducibility of Results</subject><subject>ROC Curve</subject><subject>Thyroid cancer</subject><subject>Thyroid gland</subject><subject>Thyroid Nodule - diagnostic imaging</subject><subject>Thyroid Nodule - pathology</subject><subject>Ultrasonic imaging</subject><subject>Ultrasonography - methods</subject><issn>0973-1482</issn><issn>1998-4138</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2018</creationdate><recordtype>article</recordtype><sourceid>PIMPY</sourceid><recordid>eNp1kUGLEzEUx4Mobl39AF4k4MXLrMlkZpIcpairLAhSzyGTvGnTZpKazFDm7Bc3pV0RwVPywu__3gs_hF5TctdQwt7vTZruvq6_b1SpqKL8CVpRKUXVUCaeohWRnFW0EfUNepHznpCW17V4jm4YaYUkDVmhX5sdYONdcEZ7nN02uKFcgwEcBzz7Kekc52DxNuklFwZw0pOL2AVs3TBAgjC58hK2eNTpANYveLccI5hddAbrEtXhWoxlzFjGTLslRWdxiHb2kF-iZ4P2GV5dz1v049PHzfq-evj2-cv6w0NlGsZ9xY1mHKgZRN0JW1vRUap7aCQw6AURuu60BCIG3jQ9aMN7IQ0Xbd03PbOkY7fo3aXvMcWfM-RJjS4b8L4sGOesatpR0tWCyIK-_QfdxzmFst2ZIp2QVLSFohfKpJhzgkEdU_lgWooPdTakzobU34ZK5s2189yPYP8kHpUU4P4CnKKfIOWDn0-QVGEPIZ7-31nRtuOq6FSPOtlvNDup2Q</recordid><startdate>20180101</startdate><enddate>20180101</enddate><creator>Lei, Zhi-Kai</creator><creator>Li, Ming-Kui</creator><creator>Luo, Ding-Cun</creator><creator>Han, Zhi-Jiang</creator><general>Wolters Kluwer India Pvt. 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diagnostic imaging</topic><topic>Carcinoma, Papillary - pathology</topic><topic>Clinical significance</topic><topic>Female</topic><topic>Humans</topic><topic>Image Processing, Computer-Assisted</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Neoplasm Grading</topic><topic>Reproducibility of Results</topic><topic>ROC Curve</topic><topic>Thyroid cancer</topic><topic>Thyroid gland</topic><topic>Thyroid Nodule - diagnostic imaging</topic><topic>Thyroid Nodule - pathology</topic><topic>Ultrasonic imaging</topic><topic>Ultrasonography - methods</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Lei, Zhi-Kai</creatorcontrib><creatorcontrib>Li, Ming-Kui</creatorcontrib><creatorcontrib>Luo, Ding-Cun</creatorcontrib><creatorcontrib>Han, Zhi-Jiang</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>ProQuest - 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Academic</collection><jtitle>Journal of cancer research and therapeutics</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Lei, Zhi-Kai</au><au>Li, Ming-Kui</au><au>Luo, Ding-Cun</au><au>Han, Zhi-Jiang</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>The clinical significance of ultrasound grayscale ratio in differentiating markedly hypoechoic and anechoic minimal thyroid nodules</atitle><jtitle>Journal of cancer research and therapeutics</jtitle><addtitle>J Cancer Res Ther</addtitle><date>2018-01-01</date><risdate>2018</risdate><volume>14</volume><issue>7</issue><spage>1567</spage><epage>1571</epage><pages>1567-1571</pages><issn>0973-1482</issn><eissn>1998-4138</eissn><abstract>Purpose: This study explored ultrasound grayscale ratios (USGRs) for differentiating markedly hypoechoic and anechoic minimal thyroid nodules.
Materials and Methods: Longitudinal scan images of 193 markedly hypoechoic papillary thyroid microcarcinoma (PTMC) lesions from 184 patients were retrospectively reviewed using RADinfo and compared with 123 anechoic micronodular goiters (MNGs) from 110 patients. Final diagnosis was validated by pathological examination; MNGs predominantly manifested with cyst formation. Grayscale values of PTMC, MNG, and normal surrounding tissues were obtained from grayscale histograms; USGRs (grayscale ratios of pathologic tissue to surrounding normal tissue) of PTMC and MNG were calculated. Optimal USGRs for differentiating PTMC and MNG were determined with receiver operating characteristic (ROC) curves.
Results: Among 193 PTMC and 123 MNG lesions, USGRs were 0.24-0.51 (mean ± standard deviation [SD]: 0.41 ± 0.07) and 0.01-0.38 (mean ± SD: 0.12 ± 0.08), respectively. The area under the ROC curve for distinguishing markedly hypoechoic PTMC and anechoic MNG was 0.992. As USGRs decreased, sensitivity decreased and specificity increased for MNG diagnosis. At a USGR of 0.26, the Youden index was high (0.933), corresponding to 94.3% sensitivity and 99% specificity for predicting anechoic MNG. At a USGR of 0.23, sensitivity and specificity for diagnosing anechoic MNG were 92.7% and 100%, respectively. In contrast, as USGR increased, sensitivity decreased and specificity increased for predicting PTMC. At a USGR of 0.38, sensitivity and specificity for diagnosing markedly hypoechoic PTMC were 68.4% and 100%, respectively.
Conclusions: USGRs could objectively quantize grayscale values of markedly hypoechoic and anechoic lesions, enabling accurate and quantitative determination of nodular properties.</abstract><cop>India</cop><pub>Wolters Kluwer India Pvt. Ltd</pub><pmid>30589040</pmid><doi>10.4103/jcrt.JCRT_1031_17</doi><tpages>5</tpages><oa>free_for_read</oa></addata></record> |
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subjects | Adult Aged Biopsy Calcification Carcinoma, Papillary - diagnostic imaging Carcinoma, Papillary - pathology Clinical significance Female Humans Image Processing, Computer-Assisted Male Middle Aged Neoplasm Grading Reproducibility of Results ROC Curve Thyroid cancer Thyroid gland Thyroid Nodule - diagnostic imaging Thyroid Nodule - pathology Ultrasonic imaging Ultrasonography - methods |
title | The clinical significance of ultrasound grayscale ratio in differentiating markedly hypoechoic and anechoic minimal thyroid nodules |
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