title: Differentiation of thyroid nodules in multinodular goiter with the application of technical ultrasound advances - initial results.
abstract: BACKGROUND
  To evaluate the relative value of technical ultrasound advances in differentiation of thyroid nodules in multinodular goitre.
  
  
  METHODS
  The study included patients with multinodular goitre, who were referred for thyroidectomy. Ultrasound evaluation of suspicious nodules was performed with: improved B-mode (spatial compound imaging and differential tissue harmonics), dedicated mapping of microcalcifications, mapping of the nodule vessels, and strain elastography evaluated qualitatively and semi quantitatively.
  
  
  RESULTS
  A total of 163 nodules in 124 patients with multinodular goitre were evaluated (147 benign and 16 cancers). Improved B-mode imaging was: 76.76% sensitive and 62.5% specific with AUC 0.740. Differentiating B-mode features were: shape - taller than wide OR 15.8, markedly hypoechoic OR 14.7, absence of cystic areas OR 6.6, absence of halo OR 5.0, and blurred/microlobulated margins OR 3.7. Addition of MicroPure imaging was 80.28% sensitive and 68.75% specific with AUC 0.771. MicroPure alone, power Doppler, and strain elastography were not statistically significant.
  
  
  CONCLUSIONS
  Among singular modes of ultrasound imaging, only improved B-mode imaging proved to have a significant role in differentiation of thyroid nodules in multinodular goitre. Additional gain was seen with the addition to B-mode of the mapping of microcalcifications with MicroPure imaging. Power Doppler and strain elastography did not prove to be useful techniques in multinodular goitre.
authors.affiliation: Department of Diagnostic Imaging, Second Faculty of Medicine with the English Division and the Physiotherapy Division, Medical University of Warsaw, ul. Kondratowicza 8, 03-242 Warsaw, Poland. bartoszmigda@gmail.com.
authors.forename: Bartosz
authors.initials: B
authors.lastname: Migda
authors.forename: Rafal
authors.initials: R
authors.lastname: Słapa
authors.forename: Jacek
authors.initials: J
authors.lastname: Bierca
authors.forename: Jadwiga
authors.initials: J
authors.lastname: Slowińska-Srzednicka
authors.forename: Anna
authors.initials: A
authors.lastname: Migda
authors.forename: Katarzyna
authors.initials: K
authors.lastname: Dobruch-Sobczak
authors.forename: Wiesław
authors.initials: W
authors.lastname: Jakubowski
mesh_terms: D005260:Female; D006044:Goiter, Nodular / Q000000981:diagnostic imaging* / Q000601:surgery; D006801:Humans; D008297:Male; D012680:Sensitivity and Specificity; D016606:Thyroid Nodule / Q000000981:diagnostic imaging* / Q000601:surgery; D013965:Thyroidectomy; D014463:Ultrasonography / Q000379:methods*
keywords: Doppler; elasticity imaging techniques; goiter; nodular; thyroid; ultrasonography