title: Application of Texture Analysis in the Differential Diagnosis of Benign and Malignant Thyroid Nodules: Comparison With Gray-Scale Ultrasound and Elastography.
abstract: OBJECTIVE
  The purposes of this study were to investigate the optimal subset for texture analysis by use of a histogram and cooccurrence matrix in the differential diagnosis of benign and malignant thyroid nodules and to compare the results with those of gray-scale ultrasound and elastography.
  
  
  METHODS
  From a retrospective search of an institutional database between June and November 2009, 633 solid nodules 5 mm or larger from 613 patients who underwent gray-scale ultrasound and elastography and subsequent ultrasound-guided fine-needle aspiration were included in this study. Each nodule was categorized as probably benign or suspicious of being malignant according to findings at gray-scale ultrasound and elastography. Histogram parameters (mean, SD, skewness, kurtosis, and entropy) and cooccurrence matrix parameters (contrast, correlation, uniformity, homogeneity, and entropy) were extracted from gray-scale ultrasound and elastographic images. The diagnostic performances of gray-scale ultrasound, elastography, and texture analysis for differentiating thyroid nodules were evaluated.
  
  
  RESULTS
  Gray-scale ultrasound had the best diagnostic performance with an ROC AUC (Az) of 0.809 among all parameters. Elastography had significantly poorer performance (Az = 0.646) than gray-scale ultrasound (p < 0.001). Mean extracted from gray-scale ultrasound had the highest Az (0.675) among all histogram and cooccurrence matrix parameters extracted from gray-scale ultrasound and elastographic images. However, mean and the combination of mean and gray-scale ultrasound had poorer performance than gray-scale ultrasound alone.
  
  
  CONCLUSIONS
  Using texture analysis does not improve diagnostic performance in the evaluation of thyroid cancers.
authors: 1 All authors: Department of Radiology, Research Institute of Radiological Science, Yonsei University College of Medicine, 50 Yonse-ro, Seodaemun-gu, 120-752 Seoul, Korea.
authors: Soo-Yeon
authors: SY
authors: Kim
authors: 1 All authors: Department of Radiology, Research Institute of Radiological Science, Yonsei University College of Medicine, 50 Yonse-ro, Seodaemun-gu, 120-752 Seoul, Korea.
authors: Eun-Kyung
authors: EK
authors: Kim
authors: 1 All authors: Department of Radiology, Research Institute of Radiological Science, Yonsei University College of Medicine, 50 Yonse-ro, Seodaemun-gu, 120-752 Seoul, Korea.
authors: Hee Jung
authors: HJ
authors: Moon
authors: 1 All authors: Department of Radiology, Research Institute of Radiological Science, Yonsei University College of Medicine, 50 Yonse-ro, Seodaemun-gu, 120-752 Seoul, Korea.
authors: Jung Hyun
authors: JH
authors: Yoon
authors: 1 All authors: Department of Radiology, Research Institute of Radiological Science, Yonsei University College of Medicine, 50 Yonse-ro, Seodaemun-gu, 120-752 Seoul, Korea.
authors: Jin Young
authors: JY
authors: Kwak
mesh_terms: D000328:Adult; D000368:Aged; D003937:Diagnosis, Differential; D054459:Elasticity Imaging Techniques; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D012372:ROC Curve; D012189:Retrospective Studies; D016606:Thyroid Nodule / Q000000981:diagnostic imaging* / Q000473:pathology*
keywords: elastography; gray-scale ultrasound; texture analysis; thyroid nodule