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Quantitative evaluation of contrast-enhanced ultrasound after intravenous administration of a microbubble contrast agent for differentiation of benign and malignant thyroid nodules: assessment of diagnostic accuracy

European Radiology volume 22, pages 1357–1365 (2012)Cite this article

Abstract

Objectives

To investigate the diagnostic accuracy, through quantitative analysis, of contrast-enhanced ultrasound (CEUS), using a microbubble contrast agent, in the differentiation of thyroid nodules.

Methods

This prospective study enrolled 46 patients with solitary, scintigraphically non-functional thyroid nodules. These patients were scheduled for surgery and underwent preoperative CEUS with pulse-inversion harmonic imaging after intravenous microbubble contrast medium administration. Using histology as a standard of reference, time–intensity curves of benign and malignant nodules were compared by means of peak enhancement and wash-out enhancement relative to the baseline intensity using a mixed model ANOVA. ROC analysis was performed to assess the diagnostic accuracy in the differentiation of benign and malignant nodules on CEUS.

Results

The complete CEUS data of 42 patients (31/42 [73.8%] benign and 11/42 [26.2%] malignant nodules) revealed a significant difference (P < 0.001) in enhancement between benign and malignant nodules. Furthermore, based on ROC analysis, CEUS demonstrated sensitivity of 76.9%, specificity of 84.8% and accuracy of 82.6%.

Conclusions

Quantitative analysis of CEUS using a microbubble contrast agent allows the differentiation of benign and malignant thyroid nodules and may potentially serve, in addition to grey-scale and Doppler ultrasound, as an adjunctive tool in the assessment of patients with thyroid nodules.

Key Points

• Contrast-enhanced ultrasound (CEUS) helps differentiate between benign and malignant thyroid nodules.

• Quantitative CEUS analysis yields sensitivity of 76.9% and specificity of 84.8%.

• CEUS may be a potentially useful adjunct in assessing thyroid nodules.

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Acknowledgements

The authors wish to acknowledge Ms. Mary McAllister, MA (Johns Hopkins University, Baltimore, MD, USA), for her outstanding support in editing the manuscript.

Conflict of interest

The authors have indicated they have no financial relationships relevant to this article to disclose.

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Affiliations

  1. Department of Radiology, Medical University Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria

    Ursula Nemec, Stefan F. Nemec, Michael Weber, Christian Czerny & Christian R. Krestan

  2. Department of Nuclear Medicine, Medical University Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria

    Clemens Novotny

Authors
  1. Ursula Nemec
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  2. Stefan F. Nemec
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  3. Clemens Novotny
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  4. Michael Weber
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Correspondence to Stefan F. Nemec.

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Nemec, U., Nemec, S.F., Novotny, C. et al. Quantitative evaluation of contrast-enhanced ultrasound after intravenous administration of a microbubble contrast agent for differentiation of benign and malignant thyroid nodules: assessment of diagnostic accuracy. Eur Radiol 22, 1357–1365 (2012). https://doi.org/10.1007/s00330-012-2385-6

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  • DOI: https://doi.org/10.1007/s00330-012-2385-6

Keywords

  • Thyroid nodules
  • Contrast-enhanced ultrasound
  • Pulse inversion harmonic imaging
  • Second generation microbubble contrast agent
  • Quantitative analysis