Influence of the measurement method of features in ultrasound images of the thyroid in the diagnosis of Hashimoto's disease

Introduction: This paper shows the influence of a measurement method of features in the diagnosis of Hashimoto's disease. Sensitivity of the algorithm to changes in the parameters of the ROI, namely shift, resizing and rotation, has been presented. The obtained results were also compared to the methods known from the literature in which decision trees or average gray level thresholding are used.Material: In the study, 288 images obtained from patients with Hashimoto's disease and 236 images from healthy subjects have been analyzed. For each person, an ultrasound examination of the left and right thyroid lobe in transverse and longitudinal sections has been performed.Method: With the use of the developed algorithm, a discriminant analysis has been conducted for the following five options: linear, diaglinear, quadratic, diagquadratic and mahalanobis. The left and right thyroid lobes have been analyzed both together and separately in transverse and longitudinal sections. In addition, the algorithm enabled to analyze specificity and sensitivity as well as the impact of sensitivity of ROI shift, repositioning and rotation on the measured features.Results and summary: The analysis has shown that the highest accuracy was obtained for the longitudinal section (LD) with the method of linear, yielding sensitivity = 76%, specificity = 95% and accuracy ACC = 84%. The conducted sensitivity assessment confirms that changes in the position and size of the ROI have little effect on sensitivity and specificity. The analysis of all cases, that is, images of the left and right thyroid lobes in transverse and longitudinal sections, has shown specificity ranging from 60% to 95% and sensitivity from 62% to 89%. Additionally, it was shown that the value of ACC for the method using decision trees as a classifier is equal to 84% for the analyzed data. Thresholding of average brightness of the ROI gave ACC equal to 76%

Thyroid ultrasound: State of the art part 1 - Thyroid ultrasound reporting and diffuse thyroid diseases

Accurate differentiation of focal thyroid nodules (FTL) and thyroid abnormalities is pivotal for proper diagnostic and therapeutic work-up. In these two part articles, the role of ultrasound techniques in the characterization of FTL and evaluation of diffuse thyroid diseases is described to expand on the recently published World Federation in Ultrasound and Medicine (WFUMB) thyroid elastography guidelines and review how this guideline fits into a complete thyroid ultrasound exam

Morphological imaging of the canine thyroid gland with an application towards hypothyroid dogs

Het aantal publicaties over het gebruik van medische beeldvorming bij schildklieraandoeningen bij de hond is beperkt. Beschikbare studies rapporteren enkel het gebruik van echografie (US) en planaire scintigrafie in gevallen van schildkliertumoren. De toegenomen beschikbaarheid van andere beeldvorming- technieken, zoals Computed Tomography (CT) en Magnetic Resonance Imaging (MRI), maakt deze potentieel waardevol als bijkomstige testen in de soms moeilijke diagnose en bij het opstellen van een geschikt behandelingsprotocol voor schildklieraandoeningen bij de hond. Als voorbereidende studie werd de herhaalbaarheid van US metingen bepaald. Van verschillende metingen, gemeten door verschillende onderzoekers, hadden de hoogte- en volumemetingen de grootste herhaalbaarheid. De variatie binnen de verschillende onderzoekers was kleiner dan tussen de verschillende onderzoekers. De volgende kenmerken werden echografisch waargenomen in een populatie hypothyroIde honden: hypoechogeen en heterogeen parenchym, onregelmatige aflijning van het kapsel, ronde vorm van de schildklierlob op dwarsdoorsnede en verkleind schildklier volume. De vijf parameters gecombineerd, resulteerde in een sensitiviteit van 94% in de detectie van hypothyroidie. Een continue afname in volume van de schilkier werd opgemerkt na opstarten van de behandeling. US is een gevoelige en snelle test voor het opsporen van hypothyroidie bij de hond. Een volgend hoofdstuk handelt over de CT kenmerken van de normale schildklier bij de hond. De gemiddelde pre- en post-contrast attenuatie waarden waren zeer hoog voor weke delen. Na injectie van intraveneus contrast nam het schildklier volume toe. Alle schildklierlobben zagen er homogeen uit op zowel pre- als post-contrastbeelden. De ligging, de grootte en de vorm van de schildklierlobben werden beschreven. Bijschildklieren werden niet gezien en een isthmus werd slechts bij 1 op de 25 honden aangetroffen. Gezien de uitstekende zichtbaarheid en kenmerkende eigenschappen van de normale schildklier bij de hond besloten we dat het gebruik van CT voordelig zou kunnen zijn om het onderscheid te maken tussen nekmassa’s afkomstig van schildklierweefsel en nekmassa’s van andere oorsprong. CT heeft eveneens een potentiële rol bij het stageren van schildkliertumoren. Tot slot beschreven we de MRI kenmerken van de normale schildklier. De kenmerkende vorm, ligging en intensiteit vergeleken met de omliggende structuren maakten de schildklier duidelijk herkenbaar bij alle honden. Een isthmus werd slechts bij 1 op de 44 honden aangetroffen en bijschildklieren werden niet gezien. Gezien de uitstekende zichtbaarheid en kenmerkende eigenschappen van de schildklier op MRI werd er besloten dat MRI kan bijdragen tot de diagnose van diffuse schildklieraandoeningen, bij het onderscheiden van nekmassa’s van schildklieroorsprong en andere oorsprong, en bij de stagering en operatieplanning van schildkliertumoren

Relevance of Ultrasound in the Diagnosis and Management of Malignancy of the Thyroid Disorders

BACKGROUND: The recent prevalence of ultrasonography has facilitated the early detection and qualitative evaluation of thyroid nodules – to differentiate between thyroid carcinoma and benign nodule, between metastatic lymph node and reactive node. It has moved from the suite of the radiologist to the surgeon’s office. AIM OF THE STUDY: The aim of the present study was to evaluate the relevance of SPUS in the diagnosis and surveillance of malignancy of the thyroid. METHODS: Surgeon performed ultrasound for 389 patients and the data of 350 patients who underwent total thyroidectomy was compared with the report of the RPUS, FNAC and HPE. The sensitivity, specificity, positive predictive value, negative predictive value for each was calculated. The nodule characteristics – echogenicity, margins and calcifications were analysed for correlation with malignancy. CONCLUSIONS: Surgeon who is more familiar with the anatomy and patho-physiology of thyroid disorders triages the nodule better. Multivariate analysis of nodule characteristics showed that heteroechogenicity, irregular margins and microcalcifications had a greater association with DTC after adjustment for the other characteristics

Optimizing morphology through blood cell image analysis

Introduction Morphological review of the peripheral blood smear is still a crucial diagnostic aid as it provides relevant information related to the diagnosis and is important for selection of additional techniques. Nevertheless, the distinctive cytological characteristics of the blood cells are subjective and influenced by the reviewer's interpretation and, because of that, translating subjective morphological examination into objective parameters is a challenge. Methods The use of digital microscopy systems has been extended in the clinical laboratories. As automatic analyzers have some limitations for abnormal or neoplastic cell detection, it is interesting to identify quantitative features through digital image analysis for morphological characteristics of different cells. Result Three main classes of features are used as follows: geometric, color, and texture. Geometric parameters (nucleus/cytoplasmic ratio, cellular area, nucleus perimeter, cytoplasmic profile, RBC proximity, and others) are familiar to pathologists, as they are related to the visual cell patterns. Different color spaces can be used to investigate the rich amount of information that color may offer to describe abnormal lymphoid or blast cells. Texture is related to spatial patterns of color or intensities, which can be visually detected and quantitatively represented using statistical tools. Conclusion This study reviews current and new quantitative features, which can contribute to optimize morphology through blood cell digital image processing techniques.Peer ReviewedPostprint (published version

ROLE OF ULTRASOUND IN THYROID DISORDERS

Ultrasonography has established itself has a useful tool in evaluating and managing thyroid disorders. This article provides an overview of basic principles of ultrasound, how it is used in different thyroid disorders, different sonographic pattern of thyroid disorders, comparative features of malignant and benign nodule, ultrasound features of diffuse thyroid disorders and congenital thyroid disorders, ultrasound guided FNAC, advanced techniques of ultrasound in thyroid imaging. This record was migrated from the OpenDepot repository service in June, 2017 before shutting down

The current assessment and management of thyroid nodules

Introduction. The widespread use of diagnostic imaging favored the increasing incidence of thyroid nodules. Although most of nodules are benign, their clinical importance lies in the need to exclude malignancy. In assessing and managing thyroid nodules may occur the phenomenon of overdiagnosis and overtreatment on one hand and the risk of missing an aggressive thyroid cancer on the other hand. The equilibrium that has to be reached by health care providers. Materials and methods. We conducted a PubMed, MEDLINE, ISI Web of Science, Cochrane databases search for the relevant and recent guidelines, meta-analysis, randomized controlled trial, reviews articles related to „thyroid nodules assessment”, „thyroid nodules management”, „thyroid nodules guidelines”, „thyroid nodules surgery”. Results. The initial assessment of thyroid nodules includes an evaluation of clinical, laboratory and sonographic risk factors. Due to the sonographic features and size, the nodules are selected for biopsy. Cytologically benign nodules are usually followed-up, minimally invasive techniques may be required in certain cases. In suspected or confirmed malignancy, the treatment options of thyroid nodules include surgery or active surveillance. The main controversies appear in management of nodules with inconclusive cytology, low-risk cancers, multinodular goiters, hyperfunctioning nodules, and thyroid incidentalomas. Conclusions. Thyroid nodules due to the high incidence and heterogeneity of background diseases cannot be evaluated and managed in one standardized approach. In the existing literature, there are discussed multiple options for diagnosis and treatment of thyroid nodules. We have reviewed the guidelines recommendations, novel published data, and controversial questions for health care professionals, to understand and provide efficient, personalized, and cost-effective management of patients with thyroid nodules in order to avoid automatic intensive testing and intervention and balancing each case from the patient expectations and demands

Investigating the diagnostic efficiency of a computer-aided diagnosis system for thyroid nodules in the context of Hashimoto’s thyroiditis

ObjectivesThis study aims to investigate the efficacy of a computer-aided diagnosis (CAD) system in distinguishing between benign and malignant thyroid nodules in the context of Hashimoto’s thyroiditis (HT) and to evaluate the role of the CAD system in reducing unnecessary biopsies of benign lesions.MethodsWe included a total of 137 nodules from 137 consecutive patients (mean age, 43.5 ± 11.8 years) who were histopathologically diagnosed with HT. The two-dimensional ultrasound images and videos of all thyroid nodules were analyzed by the CAD system and two radiologists with different experiences according to ACR TI-RADS. The diagnostic cutoff values of ACR TI-RADS were divided into two categories (TR4 and TR5), and then the sensitivity, specificity, and area under the receiver operating characteristic curve (AUC) of the CAD system and the junior and senior radiologists were compared in both cases. Moreover, ACR TI-RADS classification was revised according to the results of the CAD system, and the efficacy of recommended fine-needle aspiration (FNA) was evaluated by comparing the unnecessary biopsy rate and the malignant rate of punctured nodules.ResultsThe accuracy, sensitivity, specificity, PPV, and NPV of the CAD system were 0.876, 0.905, 0.830, 0.894, and 0.846, respectively. With TR4 as the cutoff value, the AUCs of the CAD system and the junior and senior radiologists were 0.867, 0.628, and 0.722, respectively, and the CAD system had the highest AUC (P < 0.0001). With TR5 as the cutoff value, the AUCs of the CAD system and the junior and senior radiologists were 0.867, 0.654, and 0.812, respectively, and the CAD system had a higher AUC than the junior radiologist (P < 0.0001) but comparable to the senior radiologist (P = 0.0709). With the assistance of the CAD system, the number of TR4 nodules was decreased by both junior and senior radiologists, the malignant rate of punctured nodules increased by 30% and 22%, and the unnecessary biopsies of benign lesions were both reduced by nearly half.ConclusionsThe CAD system based on deep learning can improve the diagnostic performance of radiologists in identifying benign and malignant thyroid nodules in the context of Hashimoto’s thyroiditis and can play a role in FNA recommendations to reduce unnecessary biopsy rates