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http://dx.doi.org/10.3348/kjr.2010.11.6.594

Role of Duplex Power Doppler Ultrasound in Differentiation between Malignant and Benign Thyroid Nodules  

Algin, Oktay (Department of Radiology, Ataturk Training and Research Hospital Bilkent)
Algin, Efnan (Department of Oncology, Gazi University Medical Faculty)
Gokalp, Gokhan (Department of Radiology, Uludag University Medical Faculty)
Ocakoglu, Gokhan (Department of Biostatistics, Uludag University Medical Faculty)
Erdogan, Cuneyt (Department of Radiology, Uludag University Medical Faculty)
Saraydaroglu, Ozlem (Department of Pathology, Uludag University Medical Faculty)
Tuncel, Ercan (Department of Endocrinology, Uludag University Medical Faculty)
Publication Information
Korean Journal of Radiology / v.11, no.6, 2010 , pp. 594-602 More about this Journal
Abstract
Objective: To evaluate the usage of duplex power Doppler ultrasound (PDUS) for the differentiation of benign and malignant thyroid nodules. Materials and Methods: We prospectively examined 77 thyroid nodules in 60 patients undergoing ultrasound-guided fine needle aspiration biopsy (FNAB). Each nodule was described according to size, inner structure, borders, parenchymal echogenicity, peripheral halo formation, and the presence of calcification (B-mode ultrasound findings). Vascularity as determined by PDUS imaging was defined as non-vascular, peripheral, central, or of mixed type. For each nodule, the pulsatility index (PI) and resistive index (RI) values were obtained. Results of FNAB and surgical pathological examination (if available) were used as a proof of final diagnosis to categorize all nodules as benign or malignant. A receiver operating characteristic (ROC) curve analysis was performed to establish cut-off, sensitivity, and specificity values associated with RI-PI values. Results: A significant relationship was observed between malignancy and irregular margins, microcalcifications, and hypoechogenicity on ultrasound examination (p < 0.05). The pattern of vascularity as determined by PDUS analysis was not a statistically significant criterion to suggest benign or malignant disease in this study (p > 0.05). The central, peripheral, and mean RI-PI values were higher in malignant nodules when compared to the other cytologies (p < 0.05). Conclusion: Vascularity is not a useful parameter for distinguishing malignant from benign thyroid nodules. However, RI and PI values are useful in distinguishing malignant from benign thyroid nodules.
Keywords
Thyroid cancer; Thyroid nodules; Power Doppler ultrasonography, RI, PI;
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