title: Preoperative prediction of papillary thyroid microcarcinoma via multiparameter ultrasound.
abstract: Background Accurate diagnosis of papillary thyroid microcarcinoma (PTMC) is important for further management. Ultrasound (US) is the most frequently used imaging modality for PTMC. Purpose To evaluate the diagnostic value of conventional US, contrast-enhanced ultrasound (CEUS) and real-time elastography (RTE) for patients with PTMC. Material and Methods In total, 135 patients with subcentimeter thyroid nodules who underwent conventional US, CEUS, and RTE before surgery were enrolled. A multivariate logistic regression analysis was performed to assess the independent predictors of PTMC. The diagnostic performances of conventional US, CEUS, and RTE were evaluated with a receiver operating characteristic (ROC) curve analysis. Results A taller-than-wide shape was identified as the strongest predictor of PTMC (odds ratio [OR], 25.21), followed by heterogeneous enhancement (OR, 24.03), marked hypoechogenicity (OR, 21.71), poorly defined margin (OR, 5.51), strain ratio (OR, 2.59), and age (OR, 0.92; all P values < 0.05). Heterogeneous enhancement on CEUS showed the highest positive predictive value (PPV; 88.0%) and an accuracy of 83.7%. A logistic regression model was created to predict PTMC using conventional US, CEUS, and RTE. The area under the ROC curve was 0.97, with a sensitivity of 88.6% and a specificity of 94.6%. Conclusion Conventional US combined with CEUS and RTE can improve the diagnostic accuracy of PTMC.
authors.affiliation: 1 Department of Ultrasound, Xuanwu Hospital, Capital Medical University, Beijing, PR China.
authors.forename: Hui Juan
authors.initials: HJ
authors.lastname: Ma
authors.affiliation: 1 Department of Ultrasound, Xuanwu Hospital, Capital Medical University, Beijing, PR China.
authors.forename: Jing Chun
authors.initials: JC
authors.lastname: Yang
authors.affiliation: 1 Department of Ultrasound, Xuanwu Hospital, Capital Medical University, Beijing, PR China.
authors.forename: Zhen Peng
authors.initials: ZP
authors.lastname: Leng
authors.affiliation: 1 Department of Ultrasound, Xuanwu Hospital, Capital Medical University, Beijing, PR China.
authors.forename: Ying
authors.initials: Y
authors.lastname: Chang
authors.affiliation: 2 Department of Surgery, Xuanwu Hospital, Capital Medical University, Beijing, PR China.
authors.forename: Hua
authors.initials: H
authors.lastname: Kang
authors.affiliation: 3 Department of Pathology, Xuanwu Hospital, Capital Medical University, Beijing, PR China.
authors.forename: Liang Hong
authors.initials: LH
authors.lastname: Teng
mesh_terms: D002291:Carcinoma, Papillary / Q000000981:diagnostic imaging*; D003287:Contrast Media; D003937:Diagnosis, Differential; D054459:Elasticity Imaging Techniques / Q000379:methods; D005260:Female; D006801:Humans; D007089:Image Enhancement / Q000379:methods; D008297:Male; D008875:Middle Aged; D011300:Preoperative Care / Q000379:methods*; D012680:Sensitivity and Specificity; D013961:Thyroid Gland / Q000000981:diagnostic imaging; D013964:Thyroid Neoplasms / Q000000981:diagnostic imaging*; D014463:Ultrasonography / Q000379:methods*; D014631:Valerates
chemical_list: D003287:Contrast Media; D014631:Valerates; C012093:Validol
keywords: Contrast-enhanced ultrasound; elastography; papillary thyroid microcarcinoma; subcentimeter nodule; ultrasound