title: Analysis of arterial dynamic micro-vascularization with contrast-enhanced ultrasound (CEUS) in thyroid lesions using external perfusion software: First results.
abstract: OBJECTIVE
  To determine different perfusion characteristics of histo-pathologically proven adenomas and carcinomas of the thyroid gland with CEUS and perfusion software.
  
  
  METHODS
  Retrospective perfusion analysis of 25 patients with carcinomas and 41 cases of adenomas of the thyroid gland (30 males, 36 females; aged 18 - 85 years, mean 56 years). All cases were histologically analyzed. Perfusion analysis was independently performed using external perfusion software (VueBox®). TTP, mTT, Peak and Rise time were calculated.
  
  
  RESULTS
  Lesions' sizes ranged from 0.2 to 10.2 cm in carcinomas (mean 2.18 cm), and from 0.6 to 5.0 cm in adenomas (mean 2.25 cm). In 20 out of 25 carcinomas that were evaluated with CEUS, a complete wash-out in the late venous phase was found. Adenomas showed wash-out at the border.Perfusion analysis in VueBox® revealed some parameters which tend to show differences between adenomas and carcinomas, however did not reach the level of significance.Median Peak in carcinomas was highest at the margins (2945 rU), and lowest in the surroundings (1110 rU). Mean Transit Time (mTT) values showed no differences between center, margin and surrounding.In adenomas healthy tissue showed higher mTT values compared to the center (24.6 vs. 20.7 sec). Median Peak was highest in the surrounding tissue and lowest in the margins (1999 vs. 1129 rU). No statistical differences could be found in the comparisons.
  
  
  CONCLUSIONS
  CEUS with perfusion analysis offers new possibilities for the dynamic evaluation of micro-vascularization in thyroid adenomas and carcinomas. Using VueBox® the perfusion analysis of the arterial phase provides new parameters that help determine a lesion's malignancy or benignity. However a final assessment regarding malignancy and benignity of thyroid lesions using only CEUS and perfusion analysis of the arterial phase is not yet possible.
authors: Department of Radiology, University Medical Center Regensburg, Regensburg, Germany.
authors: I
authors: I
authors: Wiesinger
authors: Department of Radiology, University Medical Center Regensburg, Regensburg, Germany.
authors: E
authors: E
authors: Kroiss
authors: Department of Radiology, University Medical Center Regensburg, Regensburg, Germany.
authors: N
authors: N
authors: Zausig
authors: Department of Surgery, University Medical Center Regensburg, Regensburg, Germany.
authors: M
authors: M
authors: Hornung
authors: Center of Clinical Studies, University Medical Center Regensburg, Regensburg, Germany.
authors: F
authors: F
authors: Zeman
authors: Department of Radiology, University Medical Center Regensburg, Regensburg, Germany.
authors: C
authors: C
authors: Stroszczynski
authors: Department of Radiology, University Medical Center Regensburg, Regensburg, Germany.
authors: E M
authors: EM
authors: Jung
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003287:Contrast Media / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D008297:Male; D055806:Microvessels; D008875:Middle Aged; D009389:Neovascularization, Pathologic; D010477:Perfusion / Q000379:methods*; D012189:Retrospective Studies; D013964:Thyroid Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology; D055815:Young Adult
chemical_list: D003287:Contrast Media
keywords: CEUS; Thyroid; micro-vascularization; perfusion