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Ultrasound Microvascular Blood Flow Evaluation: A New Tool for the Management of Thyroid Nodule?

BACKGROUND: Toshiba Medical System has developed a new Doppler technique [Superb Microvascular Imaging (SMI)] that has improved microvascular flow imaging. SMI depicts perinodular and intranodular thyroid microvascular flow in higher detail compared to standard colour Doppler (CD) and power Doppler...

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Autores principales: Cappelli, Carlo, Pirola, Ilenia, Gandossi, Elena, Marini, Fiorella, Cristiano, Alessandra, Casella, Claudio, Lombardi, Davide, Agosti, Barbara, Ferlin, Alberto, Castellano, Maurizio
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Hindawi 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6452547/
https://www.ncbi.nlm.nih.gov/pubmed/31019533
http://dx.doi.org/10.1155/2019/7874890
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author Cappelli, Carlo
Pirola, Ilenia
Gandossi, Elena
Marini, Fiorella
Cristiano, Alessandra
Casella, Claudio
Lombardi, Davide
Agosti, Barbara
Ferlin, Alberto
Castellano, Maurizio
author_facet Cappelli, Carlo
Pirola, Ilenia
Gandossi, Elena
Marini, Fiorella
Cristiano, Alessandra
Casella, Claudio
Lombardi, Davide
Agosti, Barbara
Ferlin, Alberto
Castellano, Maurizio
author_sort Cappelli, Carlo
collection PubMed
description BACKGROUND: Toshiba Medical System has developed a new Doppler technique [Superb Microvascular Imaging (SMI)] that has improved microvascular flow imaging. SMI depicts perinodular and intranodular thyroid microvascular flow in higher detail compared to standard colour Doppler (CD) and power Doppler (PD) imaging. OBJECTIVE: Assess the nodular microvascular architecture by SMI compared to CD and PD features in a series of thyroid nodules submitted to fine needle aspiration cytology, in order to evaluate the potential of SMI in detecting thyroid cancer. MATERIALS AND METHODS: From April 2016 to July 2017, 254 patients with thyroid nodules, evaluated as at high risk for malignancy in agreement with AACE/ACE/AME guidelines, were submitted to cytology. All nodules were previously submitted to ultrasound grayscale, CD, PD, and SMI evaluation. Benign and malignant nodules were stratified in accordance to the number of vessels visualised by SMI: score 1 with a maximum of two blood vessels and score 2 with three or more vessels. RESULTS: Score 1 was found in 59.6% of benign nodules and in 17.9% of malignant nodules, whereas score 2 was found in 40.4% and in 82.1%, respectively (sensitivity 81.7%; specificity 60.5%, p < 0.001). Variables significantly associated with malignancy in the univariate analysis were gender (OR, 0.18; 95% CI, 0.08-0.37; p < 0.001), vascularity (OR, 1.91; 95% CI, 1.65-3.89; p < 0.001), and SMI (OR, 6.72; 95% CI, 3.89-11.59; p < 0.001); multivariate logistic model confirmed SMI score 2 as an independent risk factor for malignancy (OR, 6.99; 95% CI, 3.46-12.09; p < 0.001). CONCLUSIONS: This prospective pilot study showed that SMI can depict intranodular flow in higher detail compared to CDI and PDI, thus improving thyroid cancer detection.
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spelling pubmed-64525472019-04-24 Ultrasound Microvascular Blood Flow Evaluation: A New Tool for the Management of Thyroid Nodule? Cappelli, Carlo Pirola, Ilenia Gandossi, Elena Marini, Fiorella Cristiano, Alessandra Casella, Claudio Lombardi, Davide Agosti, Barbara Ferlin, Alberto Castellano, Maurizio Int J Endocrinol Research Article BACKGROUND: Toshiba Medical System has developed a new Doppler technique [Superb Microvascular Imaging (SMI)] that has improved microvascular flow imaging. SMI depicts perinodular and intranodular thyroid microvascular flow in higher detail compared to standard colour Doppler (CD) and power Doppler (PD) imaging. OBJECTIVE: Assess the nodular microvascular architecture by SMI compared to CD and PD features in a series of thyroid nodules submitted to fine needle aspiration cytology, in order to evaluate the potential of SMI in detecting thyroid cancer. MATERIALS AND METHODS: From April 2016 to July 2017, 254 patients with thyroid nodules, evaluated as at high risk for malignancy in agreement with AACE/ACE/AME guidelines, were submitted to cytology. All nodules were previously submitted to ultrasound grayscale, CD, PD, and SMI evaluation. Benign and malignant nodules were stratified in accordance to the number of vessels visualised by SMI: score 1 with a maximum of two blood vessels and score 2 with three or more vessels. RESULTS: Score 1 was found in 59.6% of benign nodules and in 17.9% of malignant nodules, whereas score 2 was found in 40.4% and in 82.1%, respectively (sensitivity 81.7%; specificity 60.5%, p < 0.001). Variables significantly associated with malignancy in the univariate analysis were gender (OR, 0.18; 95% CI, 0.08-0.37; p < 0.001), vascularity (OR, 1.91; 95% CI, 1.65-3.89; p < 0.001), and SMI (OR, 6.72; 95% CI, 3.89-11.59; p < 0.001); multivariate logistic model confirmed SMI score 2 as an independent risk factor for malignancy (OR, 6.99; 95% CI, 3.46-12.09; p < 0.001). CONCLUSIONS: This prospective pilot study showed that SMI can depict intranodular flow in higher detail compared to CDI and PDI, thus improving thyroid cancer detection. Hindawi 2019-03-25 /pmc/articles/PMC6452547/ /pubmed/31019533 http://dx.doi.org/10.1155/2019/7874890 Text en Copyright © 2019 Carlo Cappelli et al. http://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Research Article
Cappelli, Carlo
Pirola, Ilenia
Gandossi, Elena
Marini, Fiorella
Cristiano, Alessandra
Casella, Claudio
Lombardi, Davide
Agosti, Barbara
Ferlin, Alberto
Castellano, Maurizio
Ultrasound Microvascular Blood Flow Evaluation: A New Tool for the Management of Thyroid Nodule?
title Ultrasound Microvascular Blood Flow Evaluation: A New Tool for the Management of Thyroid Nodule?
title_full Ultrasound Microvascular Blood Flow Evaluation: A New Tool for the Management of Thyroid Nodule?
title_fullStr Ultrasound Microvascular Blood Flow Evaluation: A New Tool for the Management of Thyroid Nodule?
title_full_unstemmed Ultrasound Microvascular Blood Flow Evaluation: A New Tool for the Management of Thyroid Nodule?
title_short Ultrasound Microvascular Blood Flow Evaluation: A New Tool for the Management of Thyroid Nodule?
title_sort ultrasound microvascular blood flow evaluation: a new tool for the management of thyroid nodule?
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6452547/
https://www.ncbi.nlm.nih.gov/pubmed/31019533
http://dx.doi.org/10.1155/2019/7874890
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