J Korean Soc Radiol.  2016 Jun;74(6):365-372. 10.3348/jksr.2016.74.6.365.

Virtual Touch Tissue Quantification in the Differential Diagnosis of Benign and Malignant Thyroid Nodules

• Ha SM
• Cho SW

• KMID: 2164813
• DOI: http://doi.org/10.3348/jksr.2016.74.6.365

Abstract

PURPOSE
The aim of this study was to evaluate the diagnostic utility of the virtual touch tissue quantification (VTQ) technology for differentiating between benign and malignant thyroid nodules.
MATERIALS AND METHODS
198 nodules (168 benign and 30 malignant nodules) identified in 164 patients with available VTQ velocity data and fine-needle aspiration cytology or post-surgical pathological results were included. The VTQ velocities of nodules and adjacent thyroid tissue were examined.
RESULTS
Malignant nodules had a significantly higher VTQ velocity (3.06 ± 1.04 m/s, range: 1.90-6.46 m/s) than that of benign nodules (2.40 ± 0.85 m/s, range: 0.69-8.09 m/s) (p = 0.002). The VTQ velocity ratio between malignant nodules and adjacent thyroid tissue (1.39 ± 0.43, range: 0.89-2.65) was also statistically higher than that of benign nodules (1.15 ± 0.44, range: 0.26-3.47) (p = 0.008). The area under the receiver operating characteristic curve for the VTQ velocity was 0.72 with a cutoff point of 2.37 m/s and that of the VTQ velocity ratio was 0.68 with a cutoff point of 1.26. The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy for the VTQ velocity were 86.7%, 50.6%, 23.9%, 95.5%, and 56.1%, respectively and 60.0%, 72.0%, 27.7%, 91.0%, and 70.2%, respectively for the VTQ velocity ratio.
CONCLUSION
VTQ may be helpful in differentiating malignant and benign thyroid nodules with high negative predictive value.

MeSH Terms

Biopsy, Fine-Needle
Diagnosis, Differential*
Elasticity Imaging Techniques
Humans
ROC Curve
Sensitivity and Specificity
Thyroid Gland*
Thyroid Nodule*
Ultrasonography

Figure

• 

  Fig. 1 The flow chart of the selection of the patients with thyroid nodules. Nn = number of nodules, Np = number of patients, VTQ = virtual touch tissue quantification

• 

  Fig. 2 VTQ velocity measurement and FNA of a 2.6 cm sized mixed solid-and-cystic thyroid nodule in a 70-year-old male. ROI is placed in the center of the solid portion of the nodule. FNA = fine-needle aspiration, ROI = region of interest, VTQ = virtual touch tissue quantification

• 

  Fig. 3 The median value of VTQ velocities of a 0.6 sized hypoechoic nodule that is taller than it is wide is 3.30 m/s (> 2.37 m/s: cutoff point) in a 60-year-old female with papillary thyroid carcinoma. VTQ = virtual touch tissue quantification

• 

  Fig. 4 The median VTQ velocities of a 0.8 cm sized isoechoic nodule is 2.15 m/s (< 2.37 m/s: cutoff point) in a 36-year-old male with papillary thyroid carcinoma. VTQ = virtual touch tissue quantification

• 

  Fig. 5 Nodular hyperplasia confirmed by post-surgical histopathology in a 58-year-old male. A. Conventional ultrasonography shows a 0.8 cm sized hypoechoic solid nodule with echogenic foci in the left thyroid gland. B. The median value of VTQ velocities of the nodule is 1.55 m/s (< 2.37 m/s: cutoff point). VTQ = virtual touch tissue quantification

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