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Palaniappan MK, Aiyappan SK, Ranga U. Role of Gray Scale, Color Doppler and Spectral Doppler in Differentiation Between Malignant and Benign Thyroid Nodules. J Clin Diagn Res. 2016;10(8):TC01-6doi: 10.7860/JCDR/2016/18459.8227.
Palaniappan, M. K., Aiyappan, S. K., & Ranga, U. (2016). Role of Gray Scale, Color Doppler and Spectral Doppler in Differentiation Between Malignant and Benign Thyroid Nodules. Journal of clinical and diagnostic research : JCDR, 10(8), TC01-6. https://doi.org/10.7860/JCDR/2016/18459.8227
Palaniappan, Manoj Kumar, et al. "Role of Gray Scale, Color Doppler and Spectral Doppler in Differentiation Between Malignant and Benign Thyroid Nodules." Journal of clinical and diagnostic research : JCDR vol. 10,8 (2016): TC01-6. doi: https://doi.org/10.7860/JCDR/2016/18459.8227
Palaniappan MK, Aiyappan SK, Ranga U. Role of Gray Scale, Color Doppler and Spectral Doppler in Differentiation Between Malignant and Benign Thyroid Nodules. J Clin Diagn Res. 2016 Aug;10(8):TC01-6. doi: 10.7860/JCDR/2016/18459.8227. Epub 2016 Aug 01. PMID: 27656523; PMCID: PMC5028473.
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J Clin Diagn Res. 2016 Aug;10(8):TC01-6. doi: 10.7860/JCDR/2016/18459.8227. Epub 2016 Aug 01.

Role of Gray Scale, Color Doppler and Spectral Doppler in Differentiation Between Malignant and Benign Thyroid Nodules.

Journal of clinical and diagnostic research : JCDR

Manoj Kumar Palaniappan, Senthil Kumar Aiyappan, Upasana Ranga

Affiliations

  1. Consultant, Department of Radiodiagnosis, Apollo First Med Hospitals , Chennai, Tamilnadu, India .
  2. Associate Professor, Department of Radiodiagnosis, SRM Medical College Hospital and Research Centre , Kattangulathur, Kancheepuram, Tamilnadu, India .

PMID: 27656523 PMCID: PMC5028473 DOI: 10.7860/JCDR/2016/18459.8227

Abstract

INTRODUCTION: High resolution ultrasound is the most sensitive imaging test available for the examination of the thyroid gland and due to increase in use of ultrasound more incidental thyroid nodules are diagnosed. In this study we try to establish the specific grayscale, color and spectral Doppler characteristics of malignant and benign thyroid nodules.

AIM: To determine the specific gray scale characteristics, angioarchitecture and cut-off values of Doppler indices of malignant and benign thyroid nodules. To assess the efficacy of grayscale, Doppler and combined conventional and Doppler using defined criteria in differentiating malignant from benign nodules.

MATERIALS AND METHODS: We prospectively examined 194 thyroid nodules which were confirmed on FNAC. Each nodule was described according to size, number, contents, echogenicity, margins, halo, shape, calcification, local infiltration and lymphnode enlargement. Vascularity, RI and PI values of each nodule were assessed on Doppler. Each nodule was characterized as benign, indeterminate or malignant based on grayscale and Doppler characteristics. Cut-off RI and PI values for malignant thyroid nodules were obtained by ROC.

RESULTS: Out of 194 nodules, 151 nodules were benign and 43 nodules were malignant. Significant relationship was observed between malignancy and hypoechogenicity, irregular margins, taller than wide, thick incomplete halo, micro calcifications, lymphnode enlargement and local infiltration. Intranodular vascularity was a significant criterion to suggest malignancy in thyroid nodules on color Doppler. Malignant nodules had a mean RI of 0.73 and mean PI of 1.3 which were significantly higher than the benign nodules. Accuracy of detecting malignant thyroid nodules by combining gray scale and Doppler is higher than either of them alone.

CONCLUSION: Using specific morphological pattern recognition features like microcalcifications, hypoechogenicity, taller than wide, irregular thick halo, lymphadenopathy and local extra thyroidal invasion has helped in differentiating malignant from benign features. Intranodular vascularity and high RI indices were the specific Doppler signs for malignant thyroid nodules. Since, Gray scale and Doppler have their own strengths and weaknesses, they were complementary rather than competitive modalities in diagnosing benign from malignant thyroid nodules.

Keywords: Doppler indices; Intranodular vascularity; Ultrasound

References

  1. Korean J Radiol. 2010 Nov-Dec;11(6):594-602 - PubMed
  2. Indian J Endocrinol Metab. 2015 Jul-Aug;19(4):498-503 - PubMed
  3. Radiology. 2005 Dec;237(3):794-800 - PubMed
  4. J Ultrasound Med. 1994 Feb;13(2):87-90 - PubMed
  5. AJR Am J Roentgenol. 2002 Mar;178(3):687-91 - PubMed
  6. Laryngoscope. 2008 Dec;118(12 ):2182-6 - PubMed
  7. J Ultrasound Med. 2005 Jul;24(7):897-904 - PubMed
  8. Arch Endocrinol Metab. 2015 Dec;59(6):479-81 - PubMed
  9. J Clin Endocrinol Metab. 2002 May;87(5):1938-40 - PubMed
  10. Ultraschall Med. 2007 Oct;28(5):502-6 - PubMed
  11. J Clin Endocrinol Metab. 2002 May;87(5):1941-6 - PubMed
  12. Radiol Med. 1995 May;89(5):651-7 - PubMed
  13. J Ultrasound Med. 2003 Oct;22(10 ):1027-31 - PubMed
  14. Insights Imaging. 2016 Feb;7(1):77-86 - PubMed
  15. Radiology. 2010 Apr;255 (1):260-9 - PubMed
  16. Radiol Med. 2007 Aug;112(5):751-62 - PubMed
  17. Arch Surg. 2001 Mar;136(3):334-7 - PubMed
  18. J Endocrinol Invest. 2002 Jan;25(1):39-43 - PubMed
  19. Int J Clin Exp Med. 2013 Sep 01;6(8):641-8 - PubMed
  20. J Clin Ultrasound. 2007 Feb;35(2):63-7 - PubMed
  21. Arch Endocrinol Metab. 2015 Feb;59(1):79-83 - PubMed
  22. J Ultrasound Med. 2004 Nov;23 (11):1455-64 - PubMed
  23. Ann Intern Med. 2000 Nov 7;133(9):696-700 - PubMed
  24. Clin Radiol. 2007 Mar;62(3):245-51 - PubMed
  25. J Clin Endocrinol Metab. 2006 Sep;91(9):3411-7 - PubMed
  26. Radiology. 2000 Jun;215(3):801-6 - PubMed
  27. Cancer Imaging. 2005 Dec 09;5:157-66 - PubMed
  28. Indian J Radiol Imaging. 2012 Jan;22(1):63-8 - PubMed
  29. Horm Res. 2006;66(5):249-56 - PubMed
  30. Otolaryngol Head Neck Surg. 2005 Jun;132(6):874-82 - PubMed

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