Application of Real-time Ultrasound Elastography in Diagnosing Benign and Malignant Thyroid Solid Nodules

Objective Real-time ultrasound elastography(US-E) is a helpful tool in diagnosing thyroid nodules.This study aims to evaluate thyroid solid nodules,to establish the accuracy of US-E in providing information on the nature of these nodules,and to assess the clinical value of elasticity scores(ES) and strain ratio(SR) in differentiating thyroid solid nodules and to explore its distribution characteristics using pathological analysis as reference. Methods Traditional ultrasonography and US-E were performed on 131 thyroid solid nodules(99 benign ones and 32 malignant ones) in 120 patients(78 females and 41 males).Three radiologists evaluated the nodules based on a four-degree elasticity scoring system.The nodules were classified according to the ES as soft(ES 1-2) or hard(ES 3-4).The SR was calculated online. Results The sensitivity and specificity of the ES for thyroid cancer diagnosis were 78%and 80%,respectively.SR values > 2.9 used as a standard to distinguish benign from malignant nodules had a sensitivity of 87%and a specificity of 92%.The SR of the benign lesions was 1.64±1.37,which was significantly different from that of malignant lesions,which was 4.96±2.13(P<0.01). Conclusions Both the ES and SR were higher in malignant nodules than those in benign ones.Real-time US-E was a useful index in the differential diagnosis of thyroid solid nodules.It can provide quantitative information on thyroid nodule characterization and improve diagnostic confidence.

Ultra-low-dose chest computed tomography with model-based iterative reconstruction in the analysis of solid pulmonary nodules:A prospective study

BACKGROUND Incidental pulmonary nodules are an increasingly common finding on computed tomography(CT)scans of the thorax due to the exponential rise in CT examin-ations in everyday practice.The majority of incidental pulmonary nodules are benign and correctly identifying the small number of malignant nodules is cha-llenging.Ultra-low-dose CT(ULDCT)has been shown to be effective in diagnosis of respiratory pathology in comparison with traditional standard dose techniques.Our hypothesis was that ULDCT chest combined with model-based iterative reconstruction(MBIR)is comparable to standard dose CT(SDCT)chest in the analysis of pulmonary nodules with significant reduction in radiation dose.AIM To prospectively compare ULDCT chest combined with MBIR with SDCT chest in the analysis of solid pulmonary nodules.METHODS A prospective cohort study was conducted on adult patients(n=30)attending a respiratory medicine outpatient clinic in a tertiary referral university hospital for surveillance of previously detected indeterminate pulmonary nodules on SDCT chest.This study involved the acquisition of a reference SDCT chest followed immediately by an ULDCT chest.Nodule identification,nodule characterisation,nodule measurement,objective and subjective image quality and radiation dose were compared between ULDCT with MBIR and SDCT chest.RESULTS One hundred solid nodules were detected on ULDCT chest and 98 on SDCT chest.There was no significant difference in the characteristics of correctly identified nodules when comparing SDCT chest to ULDCT chest protocols.Signal-to-noise ratio was significantly increased in the ULDCT chest in all areas except in the paraspinal muscle at the maximum cardiac diameter level(P<0.001).The mean subjective image quality score for overall diagnostic acceptability was 8.9/10.The mean dose length product,computed tomography volume dose index and effective dose for the ULDCT chest protocol were 5.592 mGy.cm,0.16 mGy and 0.08 mSv respectively.These were significantly less than the SDCT chest protocol(P<0.001)and represent a radiation dose reduction of 97.6%.CONCLUSION ULDCT chest combined with MBIR is non-inferior to SDCT chest in the analysis of previously identified solid pulmonary nodules and facilitates a large reduction in radiation dose.