Department of Ultrasound, the First Medical Centre, Chinese PLA General Hospital, No.28 Fuxing Road, Haidian District, Beijing, 100853, China.
Cancer Imaging. 2023 Oct 5;23(1):94. doi: 10.1186/s40644-023-00613-3.
The reliable ultrasound (US) measurements of papillary thyroid microcarcinoma (PTMC) are very important during active surveillance. This prospective study was design to investigate the inter-observer reliability and agreement of two- dimensional ultrasound(2DUS) and three-dimensional ultrasound(3DUS) in the measurement of maximum diameter and volume for PTMC.
This prospective study included 51 consecutive patients with solitary PTMC confirmed by biopsy. Two independent observers performed measurements of each tumor using a standardized measurement protocol. The maximum diameter was the largest one of the three diameters measured on the largest transverse and longitudinal 2DUS images. 2DUS volume was calculated using ellipsoid formula method. The virtual organ computer aided analysis(VOCAL) was used to determine 3DUS volume. The inter-observer reliability was assessed using intraclass correlation coefficient(ICC) with 95% confidence intervals(CIs). Bland-Altman analysis was used to evaluate agreement, and expressed as a bias with 95% limits of agreement(LOA).
The maximum diameter was 0.78 ± 0.14 cm. Volume measured by 3DUS was significantly smaller than that by 2DUS(0.163 ± 0.074 cm vs. 0.175 ± 0.078 cm, P = 0.005). The ICCs of inter-observer reliability of maximum diameter, 2DUS volume and 3DUS volume was 0.922(0.864-0.955), 0.928(0.874-0.959), and 0.974(0.955-0.985), respectively. The ICCs of 2DUS and 3DUS volume was 0.955(0.909-0.976). The inter-observer agreement of maximum diameter, 2DUS volume and 3DUS volume was 1.096(0.7322 to 1.459), 1.008(0.5802-1.435), and 1.011(0.7576-1.265), respectively. The inter-observer agreement of 2DUS and 3DUS volume was 1.096(0.7322 to 1.459).
Maximum diameter had the lowest degree of observer variation among all the measurements. Volume measured by 3DUS had lower variability and higher repeatability than that by 2DUS, which might be helpful to provide more reliable estimates of tumor size for PTMC.
在主动监测期间，准确的超声（US）测量对于甲状腺微小乳头状癌（PTMC）非常重要。本前瞻性研究旨在探讨二维超声（2DUS）和三维超声（3DUS）在测量 PTMC 最大直径和体积方面的观察者间可靠性和一致性。
本前瞻性研究纳入了 51 例经活检证实的单发 PTMC 患者。两名独立观察者使用标准化测量方案对每个肿瘤进行测量。最大直径是在最大横切面和最长纵切面 2DUS 图像上测量的三个直径中的最大直径。2DUS 体积使用椭圆公式法计算。使用虚拟器官计算机辅助分析（VOCAL）确定 3DUS 体积。采用 95%置信区间（CI）的组内相关系数（ICC）评估观察者间可靠性。Bland-Altman 分析用于评估一致性，并表示为 95%一致性界限（LOA）的偏差。
最大直径为 0.78±0.14cm。3DUS 测量的体积明显小于 2DUS（0.163±0.074cm 比 0.175±0.078cm，P=0.005）。最大直径、2DUS 体积和 3DUS 体积的观察者间可靠性 ICC 分别为 0.922（0.864-0.955）、0.928（0.874-0.959）和 0.974（0.955-0.985）。2DUS 和 3DUS 体积的 ICC 为 0.955（0.909-0.976）。最大直径、2DUS 体积和 3DUS 体积的观察者间一致性分别为 1.096（0.7322 至 1.459）、1.008（0.5802 至 1.435）和 1.011（0.7576 至 1.265）。2DUS 和 3DUS 体积的观察者间一致性为 1.096（0.7322 至 1.459）。
在所有测量中，最大直径的观察者变异最小。3DUS 测量的体积比 2DUS 具有更低的变异性和更高的可重复性，这可能有助于为 PTMC 提供更可靠的肿瘤大小估计。
