Quantification and classification of echographic findings in the thyroid gland by computerized B-mode texture analysis.

Computerized B-mode image analysis was investigated in a pilot study to establish quantitative criteria for thyroid echography and to demonstrate the diagnostic accuracy of the procedure in thyroid disease. The ten per cent percentile of grey level distribution and entropy proved to be the most efficient statistical parameters. Computerized ultrasound detected all nodular lesions with an overall accuracy of about 85%. Standard diagnostic evaluation in nodular thyroid disease includes conventional ultrasound followed by needle biopsy to confirm the final diagnosis. However, in many cases, single needle biopsy is not sufficient to exclude malignant disease. Computer-aided ultrasound proved to be helpful for the identification of typical echographic characteristics in thyroid lesions with a high risk of malignancy. We suggest that needle biopsies be repeated in cases in which computerized analysis is positive, even when initial needle biopsy is negative.