Contrast-Enhanced Ultrasound in the Differential Diagnosis of Primary Thyroid Lymphoma and Nodular Hashimoto’s Thyroiditis in a Background of Heterogeneous Parenchyma

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Abstract

Objective

To investigate the diagnostic performance of contrast-enhanced ultrasound (CEUS) in the differentiation of primary thyroid lymphoma (PTL) and nodular Hashimoto’s thyroiditis (NHT) in patients with background of heterogeneous diffuse Hashimoto’s thyroiditis (HT).

Methods

Sixty HT patients with 64 thyroid nodules (31 PTL and 33 NHT) who had undergone CEUS examination were included in this study. With histopathological results as the reference, we evaluated the imaging features of each nodule on both conventional ultrasonography (US) and CEUS. Quantitative CEUS parameters including peak intensity (PI), time to peak (TTP), and area under the time–intensity curve (AUC) were gathered in the nodule and background parenchyma. The ratio indexes of theses parameters were calculated by the ratio of the lesion and the corresponding thyroid parenchyma. Logistic regression and receiver operating characteristic (ROC) curves analyses of valuable US indicators were further preformed to evaluate the diagnostic capability of CEUS in discrimination of PTL and NHT.

Results

Among all the observed US imaging features and CEUS parameters, 10 indicators showed significant differences between PTL and NHT (all P < 0.05). All the significant indicators were ranked according to the odds ratios (ORs). Eight of them were CEUS associated including imaging features of enhancement pattern, degree, homogeneity, and quantification parameters of PI, AUC, ratios of PI, AUC, and TTP, while indicators on conventional US, including vascularity and size ranked the last two with ORs less than 3. The five single CEUS parameters showed good diagnostic performance in diagnosis of PTL with areas under ROC curves of 0.72–0.83 and accuracies of 70.3–75.0%. The combination of CEUS imaging features and the ratios of PI, AUC, and TTP demonstrated excellent diagnostic efficiency and achieved area under ROC curve of 0.92, which was significantly higher than any of the five single parameters (all P < 0.05), with a sensitivity of 83.9%, specificity of 87.9%, and accuracy of 85.9%.

Conclusions

CEUS is an efficient diagnostic tool in the differential diagnosis of PTL and NHT for patients with diffuse HT. Conjoint analysis of CEUS imaging features and quantification parameters could improve the diagnostic values.

Related collections

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Author and article information

Contributors

Haina Zhao: URI : https://loop.frontiersin.org/people/982086

Yushuang He: URI : https://loop.frontiersin.org/people/1052372

Yan Luo: URI : https://loop.frontiersin.org/people/1058728

Buyun Ma: URI : https://loop.frontiersin.org/people/1067200

Journal

Journal ID (nlm-ta): Front Oncol

Journal ID (iso-abbrev): Front Oncol

Journal ID (publisher-id): Front. Oncol.

Title: Frontiers in Oncology

Publisher: Frontiers Media S.A.

ISSN (Electronic): 2234-943X

Publication date (Electronic): 07 January 2021

Publication date Collection: 2020

Volume: 10

Electronic Location Identifier: 597975

Affiliations

[1] ¹ Department of Ultrasound, West China Hospital of Sichuan University , Chengdu, China

[2] ² Department of Pathology, West China Hospital of Sichuan University , Chengdu, China

Author notes

Edited by: Fu Wang, Xidian University, China

Reviewed by: Kun Zheng, Peking Union Medical College Hospital (CAMS), China; Wei Yang, Peking University Cancer Hospital, China

*Correspondence: Yan Luo, luo_yan777@ 123456163.com ; Buyun Ma, mabuyundoctor@ 123456163.com

This article was submitted to Cancer Imaging and Image-directed Interventions, a section of the journal Frontiers in Oncology

Article

DOI: 10.3389/fonc.2020.597975

PMC ID: 7817885

PubMed ID: 33489895

SO-VID: 713990ae-ece5-4a1c-bb54-c556b5646d1b

License:

This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

History

Date received : 23 August 2020

Date accepted : 16 November 2020

Page count

Figures: 4, Tables: 6, Equations: 0, References: 39, Pages: 10, Words: 5057

Funding

Funded by: National Natural Science Foundation of China 10.13039/501100001809

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