J Korean Soc Radiol.  2015 Dec;73(6):367-374. 10.3348/jksr.2015.73.6.367.

Quantitative Analysis of 3-Dimensional Volumetry and Histogram of Thyroid Gland on Neck Computed Tomography for Patients with Hashimoto's Thyroiditis

• Nam IC
• Lee KH
• Ryu J
• Kim O
• Kim SH
• Baek HJ
• Lee Y
• Kim TN
• Kim MK
• Kim SJ
• Kim SM

• KMID: 2130941
• DOI: http://doi.org/10.3348/jksr.2015.73.6.367

Abstract

PURPOSE
To analyze three-dimensional (3D) volume and histogram of thyroid gland on neck computed tomography (CT) for patients with Hashimoto's thyroiditis.
MATERIALS AND METHODS
A total of 121 subjects who underwent neck CT between March 2013 and February 2014 were included in this study. These subjects were divided into the following two groups: 1) control group (n = 76); 2) Hashimoto's thyroiditis group (n = 45). Non-enhanced and contrast-enhanced CT images were obtained. On contrast-enhanced images, the 3D volume of thyroid gland was semi-automatically calculated. On CT histogram, attenuation number, mean, median, standard deviation (SD), and coefficient of variation (CV) of thyroid gland were calculated. These values were compared between the two groups.
RESULTS
Total 3D volume of thyroid gland was 14.9 +/- 4.8 cm3 in the control group, which was significantly (p = 0.002) lower than that (19.2 +/- 8 cm3) in the Hashimoto's thyroiditis group. On CT histogram, the mean, median, SD, and CV of thyroid gland on non-enhanced images were 95.8, 99.3, 21.7, and 0.226, respectively, in the control group and 72.2, 72.6, 19.6, and 0.28 in the Hashimoto's thyroiditis group (p < 0.05). Histogram parameters on contrast-enhanced images were not significantly (p > 0.05) different. Median at cut-off value of 83 revealed the largest Az value (Az: 0.905; 95% confidence interval: 0.837-0.951; sensitivity: 84.4%; specificity: 85.5%).
CONCLUSION
The Hashimoto's thyroiditis group had larger volume but lower CT attenuation number with more prominent parenchymal heterogeneity of thyroid gland than the control group.

MeSH Terms

Hashimoto Disease
Humans
Multidetector Computed Tomography
Neck*
Population Characteristics
Sensitivity and Specificity
Thyroid Gland*
Thyroiditis*
Tomography, X-Ray Computed

Figure

• 

  Fig. 1 Flow chart of the population. CT = computed tomography, TFT = thyroid function test

• 

  Fig. 2 A 54-year-old female with Hashimoto's thyroiditis. Thyroid gland revealing heterogeneously low attenuation in nonenhanced CT image (A) and heterogeneously well enhancement in contrast-enhanced CT image (B). On 3D CT volumetry (C), the actual shape of thyroid gland is revealed, including pyramidal lobe (arrow) and total volume of 17.1 cm3. Histogram (D) reveals the distribution of CT attenuation number in the entire thyroid gland, with mean of 49.6, median of 50, standard deviation of 13.34, and coefficient of variation at 0.27. CT = computed tomography, HU = Hounsfield unit, 3D = three-dimensional

• 

  Fig. 3 Box plots showing histogram parameters of CT attenuation number on nonenhanced CT images between the two groups, including mean (A), median (B), standard deviation (C), and coefficient of variation (D). Each box stretches from the 25th percentile at lower edge to the 75th percentile at upper edge. The median is shown as a line across the box. CT = computed tomography, CV = coefficient of variation, SD = standard deviation

• 

  Fig. 4 ROC curve of histogram parameters on non-enhanced CT images, including mean (Az: 0.896, 95% CI: 0.827-0.944, sensitivity: 91.1%, specificity: 81.6%), median (Az: 0.905, 95% CI: 0.837-0.951, sensitivity: 84.4%, specificity: 85.5%), SD (Az: 0.641, 95% CI: 0.548-0.726, sensitivity: 59.1%, specificity: 75%), and CV (Az: 0.664, 95% CI: 0.572-0.747, sensitivity: 36.4%, specificity: 90.8%). CT = computed tomography, CV = coefficient of variation, SD = standard deviation

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