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Orientation of the ultrasound probe to identify the taller-than-wide sign of thyroid malignancy: a registry-based study with the Thyroid Imaging Network of Korea

PURPOSE: Although the taller-than-wide (TTW) sign has been regarded as one of the most specific ultrasound (US) features of thyroid malignancy, uncertainty still exists regarding the US probe’s orientation when evaluating it. This study investigated which US plane would be optimal to identify the TT...

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Autores principales: Hong, Min Ji, Lee, Young Hen, Kim, Ji-hoon, Na, Dong Gyu, You, Sung-Hye, Shin, Ji Eun, Kim, Seul Kee, Yang, Kyung-Sook
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Korean Society of Ultrasound in Medicine 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9816703/
https://www.ncbi.nlm.nih.gov/pubmed/36458371
http://dx.doi.org/10.14366/usg.22082
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author Hong, Min Ji
Lee, Young Hen
Kim, Ji-hoon
Na, Dong Gyu
You, Sung-Hye
Shin, Ji Eun
Kim, Seul Kee
Yang, Kyung-Sook
author_facet Hong, Min Ji
Lee, Young Hen
Kim, Ji-hoon
Na, Dong Gyu
You, Sung-Hye
Shin, Ji Eun
Kim, Seul Kee
Yang, Kyung-Sook
author_sort Hong, Min Ji
collection PubMed
description PURPOSE: Although the taller-than-wide (TTW) sign has been regarded as one of the most specific ultrasound (US) features of thyroid malignancy, uncertainty still exists regarding the US probe’s orientation when evaluating it. This study investigated which US plane would be optimal to identify the TTW sign based on malignancy risk stratification using a registry-based imaging dataset. METHODS: A previous study by 17 academic radiologists retrospectively analyzed the US images of 5,601 thyroid nodules (≥1 cm, 1,089 malignant and 4,512 benign) collected in the webbased registry of Thyroid Imaging Network of Korea through the collaboration of 26 centers. The present study assessed the diagnostic performance of the TTW sign itself and fine needle aspiration (FNA) indications via a comparison of four international guidelines, depending on the orientation of the US probe (criterion 1, transverse plane; criterion 2, either transverse or longitudinal plane). RESULTS: Overall, the TTW sign was more frequent in malignant than in benign thyroid nodules (25.3% vs. 4.6%). However, the statistical differences between criteria 1 and 2 were negligible for sensitivity, specificity, and area under the curve (AUC) based on the size effect (all P<0.05, Cohen’s d=0.19, 0.10, and 0.07, respectively). Moreover, the sensitivity, specificity, and AUC of the four FNA guidelines were similar between criteria 1 and 2 (all P>0.05, respectively). CONCLUSION: A longitudinal US probe orientation provided little additional diagnostic value over the transverse orientation in detecting the TTW sign of thyroid nodules.
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spelling pubmed-98167032023-01-11 Orientation of the ultrasound probe to identify the taller-than-wide sign of thyroid malignancy: a registry-based study with the Thyroid Imaging Network of Korea Hong, Min Ji Lee, Young Hen Kim, Ji-hoon Na, Dong Gyu You, Sung-Hye Shin, Ji Eun Kim, Seul Kee Yang, Kyung-Sook Ultrasonography Original Article PURPOSE: Although the taller-than-wide (TTW) sign has been regarded as one of the most specific ultrasound (US) features of thyroid malignancy, uncertainty still exists regarding the US probe’s orientation when evaluating it. This study investigated which US plane would be optimal to identify the TTW sign based on malignancy risk stratification using a registry-based imaging dataset. METHODS: A previous study by 17 academic radiologists retrospectively analyzed the US images of 5,601 thyroid nodules (≥1 cm, 1,089 malignant and 4,512 benign) collected in the webbased registry of Thyroid Imaging Network of Korea through the collaboration of 26 centers. The present study assessed the diagnostic performance of the TTW sign itself and fine needle aspiration (FNA) indications via a comparison of four international guidelines, depending on the orientation of the US probe (criterion 1, transverse plane; criterion 2, either transverse or longitudinal plane). RESULTS: Overall, the TTW sign was more frequent in malignant than in benign thyroid nodules (25.3% vs. 4.6%). However, the statistical differences between criteria 1 and 2 were negligible for sensitivity, specificity, and area under the curve (AUC) based on the size effect (all P<0.05, Cohen’s d=0.19, 0.10, and 0.07, respectively). Moreover, the sensitivity, specificity, and AUC of the four FNA guidelines were similar between criteria 1 and 2 (all P>0.05, respectively). CONCLUSION: A longitudinal US probe orientation provided little additional diagnostic value over the transverse orientation in detecting the TTW sign of thyroid nodules. Korean Society of Ultrasound in Medicine 2023-01 2022-07-19 /pmc/articles/PMC9816703/ /pubmed/36458371 http://dx.doi.org/10.14366/usg.22082 Text en Copyright © 2023 Korean Society of Ultrasound in Medicine (KSUM) https://creativecommons.org/licenses/by-nc/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/ (https://creativecommons.org/licenses/by-nc/4.0/) ) which permits unrestricted noncommercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Article
Hong, Min Ji
Lee, Young Hen
Kim, Ji-hoon
Na, Dong Gyu
You, Sung-Hye
Shin, Ji Eun
Kim, Seul Kee
Yang, Kyung-Sook
Orientation of the ultrasound probe to identify the taller-than-wide sign of thyroid malignancy: a registry-based study with the Thyroid Imaging Network of Korea
title Orientation of the ultrasound probe to identify the taller-than-wide sign of thyroid malignancy: a registry-based study with the Thyroid Imaging Network of Korea
title_full Orientation of the ultrasound probe to identify the taller-than-wide sign of thyroid malignancy: a registry-based study with the Thyroid Imaging Network of Korea
title_fullStr Orientation of the ultrasound probe to identify the taller-than-wide sign of thyroid malignancy: a registry-based study with the Thyroid Imaging Network of Korea
title_full_unstemmed Orientation of the ultrasound probe to identify the taller-than-wide sign of thyroid malignancy: a registry-based study with the Thyroid Imaging Network of Korea
title_short Orientation of the ultrasound probe to identify the taller-than-wide sign of thyroid malignancy: a registry-based study with the Thyroid Imaging Network of Korea
title_sort orientation of the ultrasound probe to identify the taller-than-wide sign of thyroid malignancy: a registry-based study with the thyroid imaging network of korea
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9816703/
https://www.ncbi.nlm.nih.gov/pubmed/36458371
http://dx.doi.org/10.14366/usg.22082
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