Gland and Hormone Related Diseases

All Conditions

Symptoms and General Pathology

Neoplasms

Thyroid Diseases

Body Weight

Thyroid Nodule

Endocrine System Diseases

Thyroid Neoplasms

Endocrine Gland Neoplasms

Head and Neck Neoplasms

Central Nervous System Depressants

All Drugs and Chemicals

Anti-Arrhythmia Agents

Channel Blockers

Anti-Infective Agents

Anesthetics

Lidocaine

Ethanol

First local anesthesia with lidocaine 2%, then 3 smears will be obtained for each nodule using a 20-22 gauge needle, multiple passes within the lesion will be made to obtain sufficient cells, the aspirate will be spread over a glass, fixed with ethanol 95% and submitted to the pathology department to be reported.

elastography, ultrasound

salma ahmed ragheb, assistant lecturer

Mona Gouda Maghrabi, lecturer

noha mohamed ali, assistant professor

sami Abdel_Aziz Khalil, professor

To compare the accuracy of the conventional Ultrasound 'TI-RADS', US elastography, DWI MRI, and its ADC value in characterization and differentiation of thyroid nodules.

Thyroid nodules are one of the most common endocrine carcinomata (1) Most thyroid tumors have a good prognosis if early diagnosis and timely treated (2) An Ultrasound (US) exam is a safe, non-invasive imaging technique for detecting thyroid nodules (3) However, still there are no dependable criteria to discriminate malignant from benign lesions. (4) In 2009, Horvath et al proposed the Thyroid Imaging Report and Data System (TI-RADS). The new version of TI-RADS was launched by ACR in 2017. (5) Color Doppler ultrasound is also used to differentiate benign from malignant thyroid nodules. The presence of intra-nodular vascularity (Type 1b) was considered close to be malignant (6) US elastography is a novel tool to increase the diagnostic value of Ultrasound and as an adjuvant tool (7) Shear wave elastography evaluates elasticity through the propagation speed of shear waves, with the wave speed being faster in hard tissue (8) Conventional T1-and T2-weighted MR imaging can-not differentiate benign from malignant nodules (9) Diffusion-weighted imaging (DWI) is a non-invasive tool used to distinguish benign from malignant nodules (10). Malignant thyroid nodules usually have a lower ADC value attributed to cellular density and tissue perfusion. (11) Combining subjective MRI features with a quantitative measurement could improve the diagnostic yield of DW-MRI (12) The cytological examination by fine-needle aspiration (FNA) has become a reliable tool to diagnose thyroid cancers (2) Suspicious cytological findings reach up to 30% of all aspirated nodules, suggesting the need for less invasive methods (13)

B-mode Ultrasound, Sono-Elastography, and Diffusion-weighted Imaging MRI in Thyroid Nodules

Comparative Study of B-mode Ultrasound, Sono-Elastography, and Diffusion-weighted Imaging MRI in the Characterization of Thyroid Nodules

To assess concordance of US suspicious features, US elastography results , MRI DWI, ADC value results, and the gold standard US-guided FNAB and ability to differentiate benign from malignant thyroid nodules.

compare ADC value of benign and malignant nodules to obtain a cutoff level

compare also benign and malignant nodules qualitative and quantitative elastography results.

qualitative measurement is defined as :each nodule was assigned an elasticity score based on the color pattern type according to the classification proposed by Ueno classification method (color coded map) ranging from blue to green colors. hard nodules on the map appears as blue color and soft nodules appears as red color.

Quantitative assessment of the velocity of US wave propagation through tissue. measurement units are: kilopascal (Kpa), and shear wave velocity (m/sec).

which is the most suspicious feature in ulrasound.

The five Ultrasound suspicious features are:

1. predominantly Solid nodule.
2. Marked hypoechogenicity.
3. Microlobulated or irregular margins.
4. Micro-Calcifications.
5. Taller-than-wide in shape with a ratio ≥ 1.

which pattern of color doppler study is the most suspicious:

Classified into 4 groups:

0= Avascular.

1a= Peri-nodular vascularity.

1b= Intra-nodular vascularity.

1c= Peri-nodular and intranodular vascularity.

combination of different imaging modalities which will have the best sensitivity and specificity for diagnosis of malignant thyroid nodules

Study title	NCT ID	Conditions	Interventions	Eligibility	Organization
B-mode Ultrasound, Sono-Elastography, and Diffusion-weighted Imaging MRI in Thyroid Nodules	NCT06029946	Thyroid Nodule	elastography, u...	-	Assiut University
B-mode Ultrasound, Sono-Elastography, and Diffusion-weighted Imaging MRI in Thyroid Nodules	NCT06029946	Thyroid Nodule	elastography, u...	-	Assiut University
B-mode Ultrasound, Sono-Elastography, and Diffusion-weighted Imaging MRI in Thyroid Nodules	NCT06029946	Thyroid Nodule	elastography, u...	-	Assiut University

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