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Contrast agent retention features in contrast-enhanced ultrasound: diagnostic performance for the prediction of papillary thyroid carcinoma

  • Author Footnotes
    1 Zhuang Jin and Yaqiong Zhu contributed equally to this work.
    Zhuang Jin
    Footnotes
    1 Zhuang Jin and Yaqiong Zhu contributed equally to this work.
    Affiliations
    Department of Ultrasound, General hospital of Northern Theater Command, No.83, Wenhua Road, Shenhe District, Shenyang, Liaoning province 110018, China

    Department of Ultrasound, First Medical Center of PLA General Hospital, No. 28, Fuxing Road, Haidian District, Beijing 100853, China
    Search for articles by this author
  • Author Footnotes
    1 Zhuang Jin and Yaqiong Zhu contributed equally to this work.
    Yaqiong Zhu
    Footnotes
    1 Zhuang Jin and Yaqiong Zhu contributed equally to this work.
    Affiliations
    Department of Ultrasound, First Medical Center of PLA General Hospital, No. 28, Fuxing Road, Haidian District, Beijing 100853, China
    Search for articles by this author
  • Fang Xie
    Affiliations
    Department of Ultrasound, First Medical Center of PLA General Hospital, No. 28, Fuxing Road, Haidian District, Beijing 100853, China
    Search for articles by this author
  • Yan Zhang
    Affiliations
    Department of Ultrasound, First Medical Center of PLA General Hospital, No. 28, Fuxing Road, Haidian District, Beijing 100853, China
    Search for articles by this author
  • Nan Li
    Affiliations
    Department of Ultrasound, First Medical Center of PLA General Hospital, No. 28, Fuxing Road, Haidian District, Beijing 100853, China
    Search for articles by this author
  • Yukun Luo
    Correspondence
    Correspondence to: Y. Luo, Department of Ultrasound, First Medical Center of PLA General Hospital, Beijing 100853, China.
    Affiliations
    Department of Ultrasound, First Medical Center of PLA General Hospital, No. 28, Fuxing Road, Haidian District, Beijing 100853, China
    Search for articles by this author
  • Junying Cao
    Correspondence
    Corresponding author.
    Affiliations
    Department of Ultrasound, General hospital of Northern Theater Command, No.83, Wenhua Road, Shenhe District, Shenyang, Liaoning province 110018, China
    Search for articles by this author
  • Author Footnotes
    1 Zhuang Jin and Yaqiong Zhu contributed equally to this work.

      Highlights

      • Contrast agent retention feature can predict papillary thyroid cancer with 100% specificity.
      • The existence of CAR features can be confirmed by quantitative analysis of the TIC curves.
      • The number of tumor cells and microvessel density in the retention group were higher than those in the non-retention group.

      Abstract

      Purpose

      To report a new feature of contrast-enhanced ultrasound (CEUS) and its diagnostic performance for the prediction of papillary thyroid carcinoma (PTC).

      Methods

      This retrospective study was conducted from October 2018 to March 2019, including 276 patients with 308 thyroid nodules who underwent CEUS examinations prior to surgery (90 patients, 122 nodules) or fine needle aspiration (186 patients, 186 nodules). Quantitative analysis of CEUS features was performed using time-intensity curves. After surgery, tissue sections stained with HE and an anti-CD34 primary antibody were used to characterize the cell number and microvessel density. The nodules were divided into retention and non-retention groups.

      Results

      There were 168 malignant nodules and 140 benign nodules. The contrast-agent retention (CAR) feature was only observed in 52 papillary carcinomas. The CAR feature showed the sensitivity of 30.9% albeit the high specificity of 100%, for the diagnosis of thyroid cancers. The maximum slope coefficient of the washout index was significantly lower in the retention group than in the non-retention group (P < 0.001). The enhancement intensity during the late stage of enhancement index was significantly higher in the retention group than in the non-retention group (P < 0.001). The cell number and microvessel density in nodules with CAR features were higher (P < 0.001, P = 0.004).

      Conclusion

      The combination of the retention pattern of the CEUS observed herein with other CEUS features may be a useful tool to improve the diagnostic of the PTC.

      Abbreviations:

      CEUS (contrast-enhanced ultrasound), CAR (contrast agent retention), PTC (papillary thyroid carcinoma), CNB (core needle biopsy), FNA (fine needle aspiration), IOD (integrated optical density), PPV (positive predictive value), NPV (negative predictive value), TIC (time-intensity curve), PI (peak intensity), MSCWO (maximum slope coefficient of washout), EILS (enhancement intensity during the late stage of enhancement), TSH (thyroid-stimulating hormone), A-TG (thyroglobulin antibody), A-TPO (thyroid peroxidase antibody)

      Keywords

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