Diagnostic Accuracy of Contrast-Enhanced Ultrasound Enhancement Patterns for Thyroid Nodules

Background: To evaluate the diagnostic accuracy of quantitative perfusion parameters in contrast-enhanced ultrasound to differentiate malignant from benign liver lesions. Methods: In this retrospective study 134 patients with a total of 139 focal liver lesions were included who underwent contrast enhanced ultrasound (CEUS) between 2008 and 2018. All examinations were performed by a single radiologist with more than 15 years of experience using a second-generation blood pool contrast agent. The standard of reference was histopathology (n = 60), MRI or CT (n = 75) or long-term CEUS follow up (n = 4). For post processing regions of interests were drawn both inside of target lesions and the liver background. Time–intensity curves were fitted to the CEUS DICOM dataset and the rise time (RT) of contrast enhancement until peak enhancement, and a late-phase ratio (LPR) of signal intensities within the lesion and the background tissue, were calculated and compared between malignant and benign liver lesion using Student’s t-test. Quantitative parameters were evaluated with respect to their diagnostic accuracy using receiver operator characteristic curves. Both features were then combined in a logistic regression model and the cumulated accuracy was assessed. Results: RT of benign lesions (14.8 ± 13.8 s, p = 0.005), and in a subgroup analysis, particular hemangiomas (23.4 ± 16.2 s, p < 0.001) differed significantly to malignant lesions (9.3 ± 3.8 s). The LPR was significantly different between benign (1.59 ± 1.59, p < 0.001) and malignant lesions (0.38 ± 0.23). Logistic regression analysis with RT and LPR combined showed a high diagnostic accuracy of quantitative CEUS parameters with areas under the curve of 0.923 (benign vs. malignant) and 0.929 (hemangioma vs. malignant. Conclusions: Quantified CEUS parameters are helpful to differentiate malignant from benign liver lesions, in particular in case of atypical hemangiomas.

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Differentiation between hepatocellular carcinoma and intrahepatic cholangiocarcinoma using contrast-enhanced ultrasound: A systematic review and meta-analysis

Clinical Hemorheology and Microcirculation ◽

10.3233/ch-211145 ◽

2021 ◽

pp. 1-17

Author(s):

Yanling Chen ◽

Wenping Wang

Keyword(s):

Hepatocellular Carcinoma ◽

Diagnostic Accuracy ◽

Publication Bias ◽

Likelihood Ratio ◽

Intrahepatic Cholangiocarcinoma ◽

Cochrane Library ◽

Arterial Phase ◽

Contrast Enhanced Ultrasound ◽

Diagnostic Ability ◽

Contrast Enhanced

AIM: To explore the diagnostic ability of contrast-enhanced ultrasound (CEUS) in distinguishing intrahepatic cholangiocarcinoma (ICC) from hepatocellular carcinoma (HCC). MATERIALS AND METHODS: PubMed, EMBASE, Cochrane Library, and Web of Science were systematically searched for studies reporting the diagnostic accuracy of CEUS in differentiating ICC from HCC. The diagnostic ability of CEUS was assessed based on the pooled sensitivity, specificity, diagnostic odds ratio (DOR), positive likelihood ratio (PLR), negative likelihood ratio (NLR) and area under the curve (AUC) with 95% confidence intervals (CIs). The methodologic quality was assessed by the QUADAS-2 tool. Subgroup analyses, meta-regression and investigation of publication bias were performed to identify the source of heterogeneity. RESULTS: A total of eight studies were included, consisting of 1,116 patients with HCC and 529 with ICC. The general diagnostic performance of CEUS in distinguishing ICC and HCC were as follows: pooled sensitivity, 0.92 (95% CI: 0.84–0.96); pooled specificity, 0.87 (95% CI: 0.79–0.92); pooled PLR, 7.1 (95% CI: 4.1–12.0); pooled NLR, 0.09 (95% CI: 0.05–0.19); pooled DOR, 76 (95% CI: 26–220) and AUC, 0.95(95% CI: 0.93–0.97). Different liver background may be a potential factor that influenced the diagnostic accuracy of CEUS according to the subgroup analysis, with the pooled DOR of 89.67 in the mixed liver background group and 46.87 in the cirrhosis group, respectively. Six informative CEUS features that may help differentiate HCC from ICC were extracted. The three CEUS features favoring HCC were arterial phase hyperenhancement(APHE), mild washout and late washout (>60s); the three CEUS favoring ICC were arterial rim enhancement, marked washout and early washout(<60s). No potential publication bias was observed. CONCLUSION: CEUS showed great diagnostic ability in differentiating ICC from HCC, which may be promising for noninvasive evaluation of these diseases.

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Diagnostic Value of Contrast-Enhanced Ultrasound Evaluation of Malignant and Benign Solitary Thyroid Nodules

Proceedings of the Latvian Academy of Sciences Section B Natural Exact and Applied Sciences ◽

10.1515/prolas-2016-0001 ◽

2016 ◽

Vol 70 (1) ◽

pp. 1-6 ◽

Cited By ~ 1

Author(s):

Pēteris Priedītis ◽

Maija Radziņa ◽

Ilze Štrumfa ◽

Zenons Narbuts ◽

Arturs Ozoliņs ◽

...

Keyword(s):

Contrast Enhancement ◽

Thyroid Nodules ◽

Fine Needle Biopsy ◽

Diagnostic Value ◽

Contrast Enhanced Ultrasound ◽

Clinical Value ◽

Additional Tool ◽

Ultrasound Evaluation ◽

Contrast Enhanced ◽

Benign Nodules

Abstract The aim of the study was to investigate the diagnostic value of contrast-enhanced ultrasound (CEUS) in differentiating benign and malignant thyroid nodules. Thirty-five patients with morphologically proved thyroid nodules (17 malignant; 18 benign), underwent CEUS examination. Five enhancement patterns were evaluated: vascularisation, homogeneity, presence of peripheral rim type enhancement, wash-out rate of the contrast medium, and enhancement using microvascular imaging application. Time-intensity curves (TIC) were analysed in post-processing and defined as three types: slow versus rapid and stable versus rapid biphasic wash-out. Diagnostic value of the listed CEUS parameters was calculated. The results showed medium strength correlation between morphology (benign versus malignant nodule) and type of TIC curve rs = 0.38 (p = 0.021), as well as between mode of contrast enhancement rs = 0.39 (p = 0.022) and wash-out pattern rs =0.39 (p = 0.024). The overall pooled sensitivity of selected diagnostic parameters was 82%, specificity 57%, and accuracy 70%. Malignant nodules were characterised by iso- or hypovascular contrast enhancement and slow wash-out, while benign nodules showed hypervascular enhancement with rapid wash-out TIC curve and rim-like pattern. The CEUS patterns significantly differed between malignant and benign thyroid nodules with high diagnostic accuracy. Thus, CEUS has important clinical value as an additional tool to ultrasound and fine needle biopsy.

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Perfusional pattern analysis of contrast enhanced ultrasound (CEUS) improves diagnostic accuracy and reproducibility

Digestive and Liver Disease ◽

10.1016/j.dld.2009.02.020 ◽

2009 ◽

Vol 41 (5) ◽

pp. A6

Author(s):

F. Piscaglia ◽

V. Salvatore ◽

A.G. Tewelde ◽

G. Imbriaco ◽

E. Sagrini ◽

...

Keyword(s):

Diagnostic Accuracy ◽

Pattern Analysis ◽

Contrast Enhanced Ultrasound ◽

Contrast Enhanced

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Clinical value of contrast-enhanced ultrasound enhancement patterns for differentiating solid pancreatic lesions

European Radiology ◽

10.1007/s00330-021-08243-8 ◽

2021 ◽

Author(s):

Yanjie Wang ◽

Guanghan Li ◽

Kun Yan ◽

Zhihui Fan ◽

Rong Long ◽

...

Keyword(s):

Contrast Enhanced Ultrasound ◽

Clinical Value ◽

Contrast Enhanced ◽

Ultrasound Enhancement

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Elastography in Microwave Ablation of Benign Thyroid Nodules: Relationship with Thyroid Function Levels and Contrast Enhanced Ultrasound Imagine

Ultrasound in Medicine & Biology ◽

10.1016/j.ultrasmedbio.2017.08.1273 ◽

2017 ◽

Vol 43 ◽

pp. S99

Author(s):

Qian Yang ◽

Peng Tang ◽

Guangbin He ◽

Liwen Liu ◽

Shuping Ge ◽

...

Keyword(s):

Thyroid Function ◽

Microwave Ablation ◽

Thyroid Nodules ◽

Contrast Enhanced Ultrasound ◽

Contrast Enhanced ◽

Benign Thyroid Nodules ◽

Benign Thyroid

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Effectiveness of contrast-enhanced ultrasound for detecting the staging and grading of bladder cancer: a systematic review and meta-analysis

Medical Ultrasonography ◽

10.11152/mu-2730 ◽

2020 ◽

Author(s):

Xinyue Ge ◽

Zhong-Kai Lan ◽

Jing Chen ◽

Shang-Yong Zhu

Keyword(s):

Bladder Cancer ◽

Diagnostic Accuracy ◽

Likelihood Ratio ◽

Positive Likelihood Ratio ◽

Cochrane Library ◽

Forest Plot ◽

Low Grade ◽

High Grade ◽

Contrast Enhanced Ultrasound ◽

Contrast Enhanced

Aim: The study retrospectively analysed the accuracy of preoperative contrast-enhanced ultrasound (CEUS) in differenti-ating stage Ta-T1 or low-grade bladder cancer (BC) from stage T2 or high-grade bladder cancer. Material and methods: We systematically searched the literature indexed in PubMed, Embase, and the Cochrane Library for original diagnostic articles of bladder cancer. The diagnostic accuracy of CEUS was compared with cystoscopy and/or transurethral resection of bladder tumors (TURBT). The bivariate logistic regression model was used for data pooling, couple forest plot, diagnostic odds ratio (DOR) and summary receiver operating characteristic (SROC). Results: Five studies met the selection criteria; the overall number of reported bladder cancers patients were 436. The pooled-sensitivity (P-SEN), pooled-specificity (P-SPE), pooled-positive likelihood ratio (PLR+), pooled-negative likelihood ratio (PLR−), DOR, and area under the SROC curve were 94.0% (95%CI: 85%–98%), 90% (95%CI: 83%–95%), 9.5 (95%CI: 5.1–17.6), 0.06 (95%CI: 0.02–0.17), 147 (95%CI: 35–612) and 97% (95% CI: 95%–98%) respectively. Conclusion: CEUS reaches a high efficiency in discriminating Ta-T1 or low-grade bladder cancer from stage T2 or high-grade bladder cancer. It can be a promising method in patients to distinguish T staging and grading of bladder cancer because of its high sensitivity, specificity and diagnostic accuracy.

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Exploring the Value of Radiomics Features Based on B-Mode and Contrast-Enhanced Ultrasound in Discriminating the Nature of Thyroid Nodules

Frontiers in Oncology ◽

10.3389/fonc.2021.738909 ◽

2021 ◽

Vol 11 ◽

Author(s):

Shi Yan Guo ◽

Ping Zhou ◽

Yan Zhang ◽

Li Qing Jiang ◽

Yong Feng Zhao

Keyword(s):

Diagnostic Performance ◽

Thyroid Nodules ◽

New Technologies ◽

Statistical Significance ◽

Characteristic Curve ◽

Logistic Models ◽

Contrast Enhanced Ultrasound ◽

Clinical Value ◽

Contrast Enhanced ◽

Significant Difference

BackgroundWith the improvement of ultrasound imaging resolution and the application of various new technologies, the detection rate of thyroid nodules has increased greatly in recent years. However, there are still challenges in accurately diagnosing the nature of thyroid nodules. This study aimed to evaluate the clinical application value of the radiomics features extracted from B-mode ultrasound (B-US) images combined with contrast-enhanced ultrasound (CEUS) images in the differentiation of benign and malignant thyroid nodules by comparing the diagnostic performance of four logistic models.MethodsWe retrospectively collected and ultimately included B-US images and CEUS images of 123 nodules from 123 patients, and then extracted the corresponding radiomics features from these images respectively. Meanwhile, a senior radiologist combined the thyroid imaging reporting and data system (TI-RADS) and the enhancement pattern of the ultrasonography to make a graded diagnosis of the malignancy of these nodules. Next, based on these radiomics features and grades, logistic regression was used to help build the models (B-US radiomics model, CEUS radiomics model, B-US+CEUS radiomics model, and TI-RADS+CEUS model). Finally, the study assessed the diagnostic performance of these radiomics features with a comparison of the area under the curve (AUC) of the receiver operating characteristic curve of four logistic models for predicting the benignity or malignancy of thyroid nodules.ResultsThe AUC in the differential diagnosis of the nature of thyroid nodules was 0.791 for the B-US radiomics model, 0.766 for the CEUS radiomics model, 0.861 for the B-US+CEUS radiomics model, and 0.785 for the TI-RADS+CEUS model. Compared to the TI-RADS+CEUS model, there was no statistical significance observed in AUC between the B-US radiomics model, CEUS radiomics model, B-US+CEUS radiomics model, and TI-RADS+CEUS model (P>0.05). However, a significant difference was observed between the single B-US radiomics model or CEUS radiomics model and B-US+CEUS radiomics model (P<0.05).ConclusionIn our study, the B-US radiomics model, CEUS radiomics model, and B-US+CEUS radiomics model demonstrated similar performance with the TI-RADS+CEUS model of senior radiologists in diagnosing the benignity or malignancy of thyroid nodules, while the B-US+CEUS radiomics model showed better diagnostic performance than single B-US radiomics model or CEUS radiomics model. It was proved that B-US radiomics features and CEUS radiomics features are of high clinical value as the combination of the two had better diagnostic performance.

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