Xu Lei, Zhou Yibo, Li Yingru, Lu Bin, Liu Tian
Department of Ultrasound, Jinhua Hospital of Zhejiang University, Jinhua, China.
J Ultrasound Med. 2021 Feb;40(2):227-236. doi: 10.1002/jum.15391. Epub 2020 Jul 28.
To assess the effectiveness of strain elastography (SE), Virtual Touch tissue imaging and quantification (VTIQ; Siemens Medical Solutions, Mountain View, CA) and their combination (SE + VTIQ) in distinguishing benign from malignant American College of Radiology Thyroid Imaging Reporting and Data System category 4 nodules (TR4) to reduce unnecessary biopsy.
In this retrospective study, 985 thyroid nodules from 920 patients were initially enrolled and examined with conventional ultrasound, SE, and VTIQ. The sensitivity, specificity, accuracy, positive predictive value, and negative predictive value of SE, VTIQ, and SE + VTIQ were calculated respectively. An area under the receiver operating characteristic curve analysis was applied to evaluate the diagnostic efficiency of SE, VTIQ, and SE + VTIQ in the differentiation of benign and malignant TR4 nodules.
A total of 864 patients with 922 TR4 nodules were enrolled ultimately, as 63 thyroid nodules from 56 patients were excluded because they did not meet the inclusion criteria of this study. The sensitivity, specificity, accuracy, positive predictive value, and negative predictive value of SE, VTIQ, and SE + VTIQ were 72.4% versus 86.3% versus 82.1%, 77.7% versus 80.5% versus 83.5%, 70.6% versus 76.1% versus 80.2%, 73.4% versus 76.3% versus 83.5%, and 75.5% versus 79.7% versus 82.8%, respectively. The areas under the receiver operating characteristic curve for the diagnosis of TR4 nodules by SE, VTIQ, and SE + VTIQ were 0.751, 0.817, and 0.844.
In spite of a slight decrease in the sensitivity, the application of combining SE and VTIQ techniques can improve the specificity and accuracy of TR4 nodule diagnosis, which can help reduce unnecessary biopsies of TR4 nodules.
评估应变弹性成像（SE）、虚拟触诊组织成像与量化技术（VTIQ；西门子医疗解决方案公司，加利福尼亚州山景城）及其联合应用（SE + VTIQ）在鉴别美国放射学会甲状腺影像报告和数据系统4类结节（TR4）的良恶性方面的有效性，以减少不必要的活检。
在这项回顾性研究中，最初纳入了920例患者的985个甲状腺结节，并采用传统超声、SE和VTIQ进行检查。分别计算SE、VTIQ和SE + VTIQ的敏感性、特异性、准确性、阳性预测值和阴性预测值。应用受试者操作特征曲线下面积分析来评估SE、VTIQ和SE + VTIQ在鉴别TR4结节良恶性方面的诊断效能。
最终纳入了864例患者的922个TR4结节，因为56例患者的63个甲状腺结节不符合本研究的纳入标准而被排除。SE、VTIQ和SE + VTIQ的敏感性、特异性、准确性、阳性预测值和阴性预测值分别为72.4%对86.3%对82.1%、77.7%对80.5%对83.5%、70.6%对76.1%对80.2%、73.4%对76.3%对83.5%、75.5%对79.7%对82.8%。SE、VTIQ和SE + VTIQ诊断TR4结节的受试者操作特征曲线下面积分别为0.751、0.817和0.844。
尽管敏感性略有下降，但联合应用SE和VTIQ技术可提高TR4结节诊断的特异性和准确性，有助于减少TR4结节不必要的活检。
