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  1. Article: Precision Medicine with 3D Ultrasound.

    Azizi, Ghobad / Mayo, Michelle L / Ogden, Lorna L / Farrell, Jessica / Piper, Kele / Malchoff, Carl

    VideoEndocrinology

    2023  Volume 10, Issue 2

    Abstract: Introduction: A 56-year-old woman was referred for thyroid nodules (TNs) found on a carotid ultrasonography (US). Her laboratories showed a normal thyroid stimulation hormone of 1.530 µIU/mL, normal thyroid hormone levels, and her thyroid antibodies ... ...

    Abstract Introduction: A 56-year-old woman was referred for thyroid nodules (TNs) found on a carotid ultrasonography (US). Her laboratories showed a normal thyroid stimulation hormone of 1.530 µIU/mL, normal thyroid hormone levels, and her thyroid antibodies were not elevated. Thyroid 2D US showed an isoechoic solid TN with regular margins measuring 12 × 8 × 10 mm (TR3) in the left thyroid lobe. 3D US demonstrated markedly irregular margins. The nodule volume was 0.52 cm
    Materials and methods: In our thyroid clinic, we utilize conventional 2D US and 3D US to evaluate TN for possible FNAB. Laboratory measurements were performed at Labcorp. Informed consent was given by the patient. The 3D image acquisition follows 2D US examination. The first step in 3D US image acquisition is identifying the target nodule utilizing 2D US. Next, the 3D sweep of the target nodule produces a 3D volume data set and observation of 3D-rendered images generated simultaneously from longitudinal, transverse, and coronal views. A 2D US image displays a TN only on one plane in two dimensions, longitudinal or transverse. The saved 3D volume data set can be viewed and manipulated later. We can reconstruct new images from different angles after the study is completed. The 3D image acquisition direction (front to back versus up to down) will create a different display image and volume slice. The examiner can choose the direction of 3D acquisition before 3D sweep. A 2D US image or machine lacks these qualities.
    Discussion: This case illuminates recent advances in 3D US imaging and demonstrates that this technology may enhance the value of 2D US in diagnosing malignancy. This technology allows the user to create sequential cross-sectional images through the target nodule. The addition of coronal view to the existing 2D US has been an important contributing factor. Several recent publications have reported that 3D US can improve nodule selection criteria for FNAB.
    Conclusion: We conclude that 3D US can enhance observation of TN margin irregularities and potentially improve nodule selection for FNAB.
    No competing financial interests exist.
    Runtime of video: 2 hrs 25 mins 12 secs.
    Language English
    Publishing date 2023-07-13
    Publishing country United States
    Document type Journal Article
    ISSN 2329-9738
    ISSN 2329-9738
    DOI 10.1089/ve.2023.0016
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  2. Article ; Online: 3-D Ultrasound and Thyroid Cancer Diagnosis: A Prospective Study.

    Azizi, Ghobad / Faust, Kirk / Ogden, Lorna / Been, Laura / Mayo, Michelle L / Piper, Kele / Malchoff, Carl

    Ultrasound in medicine & biology

    2021  Volume 47, Issue 5, Page(s) 1299–1309

    Abstract: This study tests the hypothesis that evaluation of thyroid nodule (TN) margin irregularities by three-dimensional ultrasound (3-D-US) distinguishes benign from malignant TNs with greater sensitivity and specificity than two-dimensional ultrasound (2-D-US) ...

    Abstract This study tests the hypothesis that evaluation of thyroid nodule (TN) margin irregularities by three-dimensional ultrasound (3-D-US) distinguishes benign from malignant TNs with greater sensitivity and specificity than two-dimensional ultrasound (2-D-US). We prospectively evaluated 344 TNs using both 2-D-US and 3-D-US followed by fine needle aspiration biopsy. TNs were divided into four groups based on the 3-D-US appearance of the margins. Bi-variate and multi-variate analyses were used. Surgical pathology confirmed 44 thyroid cancers in 40 patients. For 2-D-US, irregular margins and micro-calcifications (p < 0.001) were found more frequently in malignant TNs. Irregular margins on 2-D-US had a sensitivity and specificity of 61.4% and 79.3%, respectively. Irregular margins on 3-D-US had a sensitivity and specificity of 86.4% and 83.3%, respectively. Sensitivity, specificity, positive and negative predictive values were higher for irregular margins on 3-D-US than micro-calcifications and irregular margins on 2-D-US. Evaluation of TN margins by 3-D-US distinguished benign from malignant TNs with greater sensitivity and specificity than 2-D-US.
    MeSH term(s) Adult ; Aged ; Female ; Humans ; Imaging, Three-Dimensional ; Male ; Middle Aged ; Prospective Studies ; Sensitivity and Specificity ; Thyroid Neoplasms/diagnostic imaging ; Thyroid Nodule/diagnostic imaging ; Ultrasonography
    Language English
    Publishing date 2021-02-12
    Publishing country England
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 186150-5
    ISSN 1879-291X ; 0301-5629
    ISSN (online) 1879-291X
    ISSN 0301-5629
    DOI 10.1016/j.ultrasmedbio.2021.01.010
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    Zs.A 963: Show issues Location:
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  3. Article ; Online: Shear wave elastography and Afirma™ gene expression classifier in thyroid nodules with indeterminate cytology: a comparison study.

    Azizi, Ghobad / Keller, James M / Mayo, Michelle L / Piper, Kelé / Puett, David / Earp, Karly M / Malchoff, Carl D

    Endocrine

    2018  Volume 59, Issue 3, Page(s) 573–584

    Abstract: Purpose: To compare shear wave elastography (SWE) and Afirma™ gene expression classifier (GEC) for diagnosis of malignancy in thyroid nodules (TNs) with Bethesda Classification (BC) III or IV indeterminate cytology.: Methods: This preliminary single- ... ...

    Abstract Purpose: To compare shear wave elastography (SWE) and Afirma™ gene expression classifier (GEC) for diagnosis of malignancy in thyroid nodules (TNs) with Bethesda Classification (BC) III or IV indeterminate cytology.
    Methods: This preliminary single-center prospective study was approved by the Institutional Review Board. We evaluated 151 consented patients with 151 indeterminate TNs (123 BC III, 28 BC IV) on fine-needle aspiration biopsy (FNAB). B-mode ultrasound, vascularity, and SWE were performed prior to FNAB. TN stiffness was measured as shear wave velocity (SWV) in meters per second (m/s). The stiffest area of the TN was selected for SWV measurement. GEC testing was performed with a second FNAB. Surgery was recommended for GEC-suspicious TNs, or GEC-benign TNs with two or more worrisome B-mode US features.
    Results: Surgical pathology confirmed 31 malignant TNs. Among the GEC-suspicious group, 28 of 59 TNs were malignant. The SWV value of ≥3.59 m/s was the best cut-off for malignancy risk based on the receiver operating curve (ROC). Twenty-six malignant TNs had SWV ≥ 3.59 m/s. The sensitivity and specificity for SWV ≥ 3.59 m/s were 83.9 and 79.2%, respectively. Positive predictive value (PPV) was 51.0% and negative predictive value (NPV) was 95.0%. For the GEC-suspicious group, sensitivity, specificity, PPV, and NPV were 90.3, 74.2, 47.5, and 96.7%, respectively. In multivariate analysis, SWV and GEC-suspicious were significant predictors of malignancy, but B-mode features and vascularity were not.
    Conclusion: This preliminary study indicates that SWE and GEC are independent predictors of malignancy in TNs with BC III or IV.
    MeSH term(s) Adult ; Aged ; Biopsy, Fine-Needle ; Elasticity Imaging Techniques/methods ; Female ; Gene Expression Profiling ; Humans ; Male ; Middle Aged ; Prospective Studies ; Sensitivity and Specificity ; Thyroid Gland/diagnostic imaging ; Thyroid Gland/pathology ; Thyroid Nodule/diagnostic imaging ; Thyroid Nodule/genetics ; Thyroid Nodule/pathology
    Language English
    Publishing date 2018-01-19
    Publishing country United States
    Document type Comparative Study ; Journal Article
    ZDB-ID 1194484-5
    ISSN 1559-0100 ; 1355-008X ; 0969-711X
    ISSN (online) 1559-0100
    ISSN 1355-008X ; 0969-711X
    DOI 10.1007/s12020-017-1509-9
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    Zs.A 3884: Show issues Location:
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  4. Article ; Online: Shear Wave Elastography and Cervical Lymph Nodes: Predicting Malignancy.

    Azizi, Ghobad / Keller, James M / Mayo, Michelle L / Piper, Kelé / Puett, David / Earp, Karly M / Malchoff, Carl D

    Ultrasound in medicine & biology

    2016  Volume 42, Issue 6, Page(s) 1273–1281

    Abstract: This prospective study evaluates the accuracy of virtual touch imaging quantification (VTIQ), a non-invasive shear wave elastography method for measuring cervical lymph nodes (LN) stiffness in differentiating benign from malignant LN. The study evaluated ...

    Abstract This prospective study evaluates the accuracy of virtual touch imaging quantification (VTIQ), a non-invasive shear wave elastography method for measuring cervical lymph nodes (LN) stiffness in differentiating benign from malignant LN. The study evaluated 270 LN in 236 patients with both conventional B-mode ultrasound and VTIQ shear wave elastography before fine-needle aspiration biopsy (FNAB). LN stiffness was measured as shear wave velocity (SWV) in m/s. Surgical resection was advised for FNAB results that were not clearly benign. Surgical pathology confirmed 54 malignant LN. The receiver operating curve (ROC) identified a single cut-off value of 2.93 m/s as the maximum SWV for predicting a malignant cervical LN. The sensitivity and specificity were 92.59% and 75.46%, respectively. Positive predictive value (PPV) was 48.54% and negative predictive value (NPV) was 97.60%. LN stiffness measured by VTIQ-generated shear wave elastography is an independent predictor of malignancy.
    MeSH term(s) Diagnosis, Differential ; Elasticity Imaging Techniques/methods ; Female ; Humans ; Lymph Nodes/diagnostic imaging ; Lymph Nodes/pathology ; Lymphatic Metastasis ; Male ; Middle Aged ; Neck ; Predictive Value of Tests ; Prospective Studies ; ROC Curve ; Reproducibility of Results ; Sensitivity and Specificity ; Thyroid Neoplasms/pathology
    Language English
    Publishing date 2016
    Publishing country England
    Document type Journal Article
    ZDB-ID 186150-5
    ISSN 1879-291X ; 0301-5629
    ISSN (online) 1879-291X
    ISSN 0301-5629
    DOI 10.1016/j.ultrasmedbio.2016.01.012
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    Zs.A 963: Show issues Location:
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  5. Article ; Online: Shear wave elastography and parathyroid adenoma: A new tool for diagnosing parathyroid adenomas.

    Azizi, Ghobad / Piper, Kelé / Keller, James M / Mayo, Michelle L / Puett, David / Earp, Karly M / Malchoff, Carl D

    European journal of radiology

    2016  Volume 85, Issue 9, Page(s) 1586–1593

    Abstract: Objectives: This study prospectively determines the shear wave elastography characteristics of parathyroid adenomas using virtual touch imaging quantification, a non-invasive ultrasound based shear wave elastography method.: Methods: This prospective ...

    Abstract Objectives: This study prospectively determines the shear wave elastography characteristics of parathyroid adenomas using virtual touch imaging quantification, a non-invasive ultrasound based shear wave elastography method.
    Methods: This prospective study examined 57 consecutive patients with biochemically proven primary hyperparathyroidism and solitary parathyroid adenoma identified by ultrasound and confirmed by at least one of the following: surgical resection, positive Technetium-99m Sestamibi Scintigraphy (MIBI) scan, or fine needle aspiration biopsy with positive PTH washout (performed only in MIBI negative patients). Vascularity and shear wave elastography were performed for all patients. Parathyroid adenoma stiffness was measured as shear wave velocity in meters per second.
    Results: The median (range) pre-surgical value for PTH and calcium were 58pg/mL (19, 427) and 10.8mg/dL (9.5, 12.1), respectively. 37 patients had positive MIBI scan. 20 patients had negative MIBI scan but diagnosis was confirmed with positive PTH washout. 42 patients underwent parathyroidectomy, and an adenoma was confirmed in all. The median (range) shear wave velocity for all parathyroid adenomas enrolled in this study was 2.02m/s (1.53, 2.50). The median (range) shear wave velocity for thyroid tissue was 2.77m/s (1.89, 3.70). The shear wave velocity of the adenomas was independent of adenoma size, serum parathyroid hormone concentration, or plasma parathyroid hormone concentration.
    Conclusions: Tissue elasticity of parathyroid adenoma is significantly lower than thyroid tissue. B-mode features and distinct vascularity pattern are helpful tools in diagnosing parathyroid adenoma with ultrasound. Shear wave elastography may provide valuable information in diagnosing parathyroid adenoma.
    MeSH term(s) Adult ; Aged ; Aged, 80 and over ; Elasticity Imaging Techniques/methods ; Female ; Humans ; Male ; Middle Aged ; Parathyroid Glands/diagnostic imaging ; Parathyroid Neoplasms/complications ; Parathyroid Neoplasms/diagnostic imaging ; Prospective Studies ; Reproducibility of Results ; Young Adult
    Language English
    Publishing date 2016-09
    Publishing country Ireland
    Document type Journal Article
    ZDB-ID 138815-0
    ISSN 1872-7727 ; 0720-048X
    ISSN (online) 1872-7727
    ISSN 0720-048X
    DOI 10.1016/j.ejrad.2016.06.009
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    Zs.A 1630: Show issues Location:
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  6. Article ; Online: Thyroid Nodules and Shear Wave Elastography: A New Tool in Thyroid Cancer Detection.

    Azizi, Ghobad / Keller, James M / Mayo, Michelle L / Piper, Kelé / Puett, David / Earp, Karly M / Malchoff, Carl D

    Ultrasound in medicine & biology

    2015  Volume 41, Issue 11, Page(s) 2855–2865

    Abstract: This study determines the performance of virtual touch imaging quantification (VTIQ), a non-invasive shear wave elastography method for measuring thyroid nodule (TN) stiffness, in distinguishing benign from malignant TNs. This prospective study evaluates ...

    Abstract This study determines the performance of virtual touch imaging quantification (VTIQ), a non-invasive shear wave elastography method for measuring thyroid nodule (TN) stiffness, in distinguishing benign from malignant TNs. This prospective study evaluates 707 TNs in 676 patients with fine-needle aspiration biopsy (FNAB). Before FNAB, both conventional B-mode ultrasound and shear wave elastography were performed. Surgical resection was recommended for FNAB results that were not clearly benign. Surgical pathology confirmed 82 malignant TNs. The receiver operating curve identified a single cut-off of 3.54 m/s as the maximum shear wave velocity (SWV) for predicting thyroid cancer (TC). The sensitivity and specificity were 79.27% and 71.52%, respectively. Positive predictive value (PPV) was 26.75% and negative predictive value (NPV) was 96.34%. Compared with B-mode US features for predicting malignancy, SWV ≥3.54 m/s has a higher sensitivity, specificity, PPV and NPV. TN stiffness measured by VTIQ-generated shear wave elastography is an independent predictor of TC.
    MeSH term(s) Adolescent ; Adult ; Aged, 80 and over ; Diagnosis, Differential ; Elasticity Imaging Techniques/methods ; Female ; Humans ; Male ; Middle Aged ; Prospective Studies ; ROC Curve ; Reproducibility of Results ; Sensitivity and Specificity ; Thyroid Gland/diagnostic imaging ; Thyroid Nodule/diagnostic imaging ; Young Adult
    Language English
    Publishing date 2015-11
    Publishing country England
    Document type Journal Article
    ZDB-ID 186150-5
    ISSN 1879-291X ; 0301-5629
    ISSN (online) 1879-291X
    ISSN 0301-5629
    DOI 10.1016/j.ultrasmedbio.2015.06.021
    Database MEDical Literature Analysis and Retrieval System OnLINE

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