title: An Algorithm of Image Heterogeneity with Contrast-Enhanced Ultrasound in Differential Diagnosis of Solid Thyroid Nodules.
abstract: Enhancement heterogeneity on contrast-enhanced ultrasonography (CEUS) is used to differentiate between benign and malignant thyroid nodules. In this study, we used an algorithm to quantify enhancement heterogeneity of solid thyroid nodules on CEUS. The heterogeneity value (HV) is calculated as standard deviation/mean intensity × 100 (using Adobe Photoshop). The heterogeneity ratio (HR) is calculated as the ratio of the HV of the nodule to that of the surrounding parenchyma. Three phases-ascending, peak and descending phases-were studied. HV values at ascending (HVa) and peak (HVp) phases were significantly higher in malignant nodules than in benign nodules (95.57 ± 43.87 vs. 73.06 ± 44.04, p = 0.009, and 32.53 ± 10.73 vs. 26.44 ± 8.25, p = 0.002, respectively). HRa, HRpand HRdwere significantly higher in malignant nodules than in benign nodules (1.93 ± 1.03 vs. 1.00 ± 0.47, p = 0.000, 1.43 ± 0.51 vs. 1.09 ± 0.28, p = 0.000, and 1.33 ± 0.40 vs. 1.08 ± 0.33, p = 0.001, respectively). HRaachieved optimal diagnostic performance on receiver operating characteristic curve analysis. The algorithm used for assessment of image heterogeneity on CEUS examination may be a useful adjunct to conventional ultrasound for differential diagnosis of solid thyroid nodules.
authors.affiliation: Department of Ultrasound, Shanghai General Hospital, Shanghai Jiao Tong University, Shanghai, China.
authors.forename: Lifang
authors.initials: L
authors.lastname: Jin
authors.affiliation: Department of Ultrasound, Shanghai General Hospital, Shanghai Jiao Tong University, Shanghai, China; Department of Ultrasound, Huai'an First People's Hospital, Nanjing Medical University, Jiangsu, China.
authors.forename: Changsong
authors.initials: C
authors.lastname: Xu
authors.affiliation: Department of Radiology, Shanghai General Hospital, Shanghai Jiao Tong University, Shanghai, China.
authors.forename: Xueqian
authors.initials: X
authors.lastname: Xie
authors.affiliation: Department of Ultrasound, Shanghai General Hospital, Shanghai Jiao Tong University, Shanghai, China.
authors.forename: Fan
authors.initials: F
authors.lastname: Li
authors.affiliation: Department of Pathology, Shanghai General Hospital, Shanghai Jiao Tong University, Shanghai, China.
authors.forename: Xiuhong
authors.initials: X
authors.lastname: Lv
authors.affiliation: Department of Ultrasound, Shanghai General Hospital, Shanghai Jiao Tong University, Shanghai, China. Electronic address: lianfang_du@126.com.
authors.forename: Lianfang
authors.initials: L
authors.lastname: Du
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000465:Algorithms; D003287:Contrast Media; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D007089:Image Enhancement / Q000379:methods*; D008297:Male; D008875:Middle Aged; D013961:Thyroid Gland / Q000000981:diagnostic imaging; D016606:Thyroid Nodule / Q000000981:diagnostic imaging*; D014463:Ultrasonography / Q000379:methods*; D055815:Young Adult
chemical_list: D003287:Contrast Media
keywords: Contrast; Diagnosis; Heterogeneity; Thyroid nodule; Ultrasound