Diagnostic value of 3D power Doppler ultrasound in the characterization of thyroid nodules

Abstract

Background/aim: This study aimed to evaluate the diagnostic value of vascular indices obtained using 3D power Doppler ultrasound(3D PDUS) in differentiation of benign and malignant thyroid nodules.Materials and methods: Sixty-seven patients (56 female, 11 male, mean age 44.6) with 81 thyroid nodules exhibiting mixed (peripheraland central) vascularization patterns, with the largest diameter between 10 and 30 mm, were prospectively evaluated using 3D PDUS.Nodule volume, vascularization index (VI), flow index (FI), and vascularization flow index (VFI) were calculated using the VirtualOrgan Computer-aided Analysis (VOCAL) software, and these indices were then compared with regard to the cytohistopathologybased diagnosis. The optimum cutoff values for the differentiation of benign and malignant nodules were identified, and diagnosticefficacy was calculated using receiver operating characteristic (ROC) analysis.Results: Fifty-six of the 81 nodules included in this study were diagnosed as benign and 25 as malignant. Vascular indices in malignantnodules were significantly higher than those in benign nodules (P < 0.05). In benign nodules, the mean VI was 11.61 ± 6.88, mean FI was39.75 ± 3.93, and mean VFI was 4.82 ± 2.94, compared to 18.64 ± 12.81, 41.82 ± 4.43, and 8.17 ± 6.37, respectively, in malignant nodules.The area under the curves (AUCs) was calculated as 0.68, 0.61, and 0.67 for VI, FI, and VFI, respectively. At optimal cutoff values of 10.2for VI, 40.8 for FI, and 5.5 for VFI, the sensitivity and specificity were 72%/55.4%, 68%/57.1%, and 68%/67.9%, respectively.Conclusion: 3D PDUS can be useful in the characterization of thyroid nodules.