Off-site evaluation of three-dimensional ultrasound for the diagnosis of thyroid nodules: comparison with two-dimensional ultrasound
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We compared the diagnostic performance of off-site evaluation between prospectively obtained 3D and 2D ultrasound for thyroid nodules.
3D and 2D ultrasonographies were preoperatively obtained from 85 consecutive patients (mean age, 51 years; age range, 28–83 years) who were referred for a total thyroidectomy. Three radiologists independently evaluated 3D and 2D images of 91 pathologically confirmed thyroid nodules (30 benign and 61 malignant nodules) for nodule characterization. Diagnostic performance, interobserver agreement and time for scanning were compared between 3D and 2D.
3D had significantly higher sensitivities than 2D for predicting malignancy (78.7 % vs. 61.2 %, P < 0.01) and extrathyroidal extension (66.7 % vs. 46.4 %, P = 0.03) in malignancy. In terms of specificities, there were no statistically significant differences between 2D and 3D for predicting malignancy (78.4 % vs. 74.8 %, P = 1.00) and extrathyroidal extension (63.6 % vs. 57.6 %, P = 0.46). With respect to interobserver agreement, 3D showed moderate agreement (κ = 0.53) for predicting extrathyroidal extension in malignancy compared with 2D ultrasound, which showed fair agreement (κ = 0.37). 3D saved time (30 ± 56.52 s) for scanning compared with 2D.
For off-site evaluation, 3D US is more useful for diagnosis of thyroid nodules than 2D US.
• 3D had higher sensitivity than 2D for predicting malignancy and extrathyroidal extension.
• 3D showed better agreement for predicting extrathyroidal extension in malignancy than 2D.
• 3D thyroid ultrasound saved time for scanning compared with 2D.
• For off-site evaluation of thyroid nodules, 3D is more useful than 2D.
KeywordsTwo-dimensional ultrasound Three-dimensional ultrasound Thyroid nodule Diagnosis Off-site evaluation
The scientific guarantor of this publication is Chul-Ho Sohn. The authors of this manuscript declare no relationships with any companies whose products or services may be related to the subject matter of the article. This study has received funding by Research Fund of Seoul National University (800–20130043). We thank Kyung-ha Seo, our colleague from the Medical Research Collaborating Centre who provided statistical support. Institutional review board approval was obtained. Written informed consent was obtained from all patients in this study. Methodology: prospective, diagnostic or prognostic, single-centre study.
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