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OBJECTIVE. This retrospective study aimed to investigate the capability of the already-proposed thyroid imaging reporting and data system for detecting diffuse thyroid disease (DTD-TIRADS) on ultrasound (US) by assessing interobserver agreement and diagnostic performance. MATERIALS AND METHODS. A total of 180 patients who underwent thyroid US before thyroid surgery were included. Three radiologists blinded to the pathologic and serologic data independently categorized the US features according to a four-category DTD-TIRADS classification system. On the basis of the pathologic results of thyroid parenchyma, diagnostic performance values were calculated using ROC curve analyses. Interobserver agreements of each US feature and DTD-TIRADS category among the three radiologists were also assessed. RESULTS. Of the 180 patients, 143 (79.4%) had normal thyroid parenchyma and 37 (20.6%) had diffuse thyroid disease (DTD). The areas under the ROC curve for DTD were not significantly different among the three radiologists: 0.876 (95% CI, 0.819-0.920) for radiologist 1, 0.883 (95% CI, 0.827-0.926) for radiologist 2, and 0.861 (95% CI, 0.801-0.908) for radiologist 3 ( p > .05). The cutoff for the diagnosis of DTD was category III DTD-TIRADS. The sensitivity, specificity, and accuracy of DTD-TIRADS for detecting DTD were 86.5%, 81.1%, and 82.2% for radiologist 1; 86.5%, 83.2%, and 83.9% for radiologist 2; and 83.8%, 82.5%, and 82.8% for radiologist 3, respectively. Interobserver agreement of DTD-TIRADS categorization was almost perfect (κ = 0.81). CONCLUSION. DTD-TIRADS has high diagnostic performance and almost-perfect interobserver agreement. Thus, DTD-TIRADS can be considered to be an effective classification system for diagnosing DTD.

Objective: This study aimed to compare ultrasonography (US) features and the Korean-Thyroid Imaging Reporting and Data System (K-TIRADS) categories for diagnosing isthmic and lobar papillary thyroid carcinomas (PTC). Methods: From January 2009 to December 2012, 163 patients who underwent thyroid surgery and were confirmed with a post-operative histopathological diagnosis of isthmic PTC were retrospectively included. Fifty-nine patients were excluded because their tumor size was <0.5 cm or because of other reasons. The control group comprised of 145 patients who underwent thyroid surgery from January to April 2013 for a classic type of PTC, with the largest diameter being ≥ 0.5 cm and located in the thyroid lobe. A single radiologist retrospectively reviewed the US features and K-TIRADS categories of each nodule using a picture archiving and communication system. Results: Among 104 patients with isthmic PTC, 95 and 9 had primary and secondary cancers, respectively. On the other hand, all 145 patients with lobar PTC had primary cancers. Isthmic PTC showed a lower prevalence of non-parallel orientation than lobar PTC (23.1 and 71%). Nodule orientation was the only US feature statistically different between the two groups ( p < 0.0001). However, there was no significant difference in patient age, sex, nodule size, composition, echogenicity, microcalcification, spiculated/microlobulated margin, and K-TIRADS category between the two groups ( p > 0.05). Conclusions: K-TIRADS may be useful in the diagnosis of both isthmic and lobar PTC., (Copyright © 2020 Lee, Kim, Shin, Park, Choo, Park, Ha, Kim, Jung, Park, Moon, Ahn and Baek.)

BACKGROUND This study aimed to assess the utility and characteristics of preoperative ultrasonography (US) in patients transferred to referral hospitals from local clinics with a diagnosis of malignancy on US-guided fine-needle aspiration cytology of thyroid nodules. MATERIAL AND METHODS From January 2018 to June 2018, 109 transferred patients underwent preoperative US in our hospital for suspected thyroid malignancy on cytological analysis after US-guided fine-needle aspiration of thyroid nodules in local clinics. Preoperative US was performed by a single radiologist in all patients. Among them, 6 were excluded from the study because of refusal of thyroid surgery. Preoperative US and histopathological results were compared in all patients. RESULTS After thyroid surgery, pathological examination revealed papillary thyroid carcinoma (PTC) (n=98), follicular adenoma (n=1), and nodular hyperplasia (n=4). Of the 103 patients, 91 exhibited suspicious US findings on the preoperative US, whereas 12 did not. In the 91 patients with suspicious US findings, PTC (n=90) and follicular adenoma (n=1) were confirmed after thyroid surgery. In the 12 patients with no suspicious US findings, PTC (n=8) and nodular hyperplasia (n=4) were confirmed after thyroid surgery. On repeat analysis of the cytological slides of the 4 nodular hyperplasia cases from the local clinics, Bethesda category II (n=1) and III (n=3) were determined. CONCLUSIONS In the transferred patients with a malignant cytology, preoperative US might be helpful to detect false-positive cytology cases.

This study aimed to compare diagnostic accuracy of real-time and static ultrasonography (US) for differentiating diffuse thyroid disease (DTD) from normal thyroid parenchyma (NTP). At 4 participating institutions, 203 patients underwent real-time thyroid US before thyroid surgery. For static US, the same radiologists retrospectively evaluated US findings on a picture archive and communication system after 4 weeks. In real-time and static US diagnoses, US category included no DTD, indeterminate, suspicious for DTD, and DTD. We investigated the diagnostic accuracy of real-time and static US with a receiver operating characteristic curve analysis using histopathologic results as the reference standard. Histopathologic results exhibited NTP (n = 139), Hashimoto thyroiditis (n = 24), non-Hashimoto lymphocytic thyroiditis (n = 33), and diffuse hyperplasia (n = 7). Of 203 patients, there were significant differences in echogenicity, echotexture, glandular margin, and vascularity of the thyroid gland and US category between NTP and DTD groups in both real-time and static US diagnoses (P < 0.001). The diagnostic indices of real-time and static US were highest when the cutoff criterion was chosen as 1 or more abnormal US features. In addition, US category was the only feature with a significant difference between DTD and NTP groups regardless of the practical experience. The receiver operating characteristic curve analysis showed that real-time US was superior to static US in the diagnostic accuracy; however, there was no significant difference (P = 0.09). In conclusion, real-time and static US can be helpful for detecting incidental DTD by using US classification based on abnormal US features.

This study aimed to assess the prevalence of tumor recurrence/persistence and determine the appropriate frequency and interval of follow-up neck ultrasonography (US) in papillary thyroid microcarcinoma (PTMC) patients who underwent hemithyroidectomy and long-term follow-up US. From January 2005 to December 2006, 179 patients underwent a hemithyroidectomy for the treatment of PTMC and at least 1 postoperative US surveillances. The postoperative follow-up US was performed by 2 radiologists for all patients. Based on the US and histopathologic results, tumor recurrence/persistence was determined. Of the 179 patients, the following results were determined after hemithyroidectomy: all patients exhibited T1 stage, while nodal metastasis to the ipsilateral level VI node (n = 27) and ipsilateral multifocality (n = 16) were found. Tumor recurrence was found in 5 (2.8%) of 179 and tumor persistence in 2 (1.1%) of 179. In the tumor recurrence cases, all patients underwent US-guided fine-needle aspiration for the newly detected thyroid nodule because of suspicious features on postoperative follow-up US (8-, 24-, 36-, 87-, and 96-month intervals). Differences were observed in the number of follow-up US sessions (mean, 5.2; range, 1-13) and in the interval period to the last follow-up (mean, 80.7 months; range, 8-138 months). Among the patients, 82 (45.8%) had a more than 120-month interval to the last follow-up US after hemithyroidectomy. In conclusion, the PTMC tumor recurrence rate was low, indicating that only 1 or 2 sessions of postoperative US follow-up may be sufficient to detect tumor recurrence within the first 10 years after hemithyroidectomy in PTMC patients.

This study aimed to assess ultrasonography (US) features of normal submandibular parenchyma (NSP) and incidental diffuse submandibular disease (DSD). From January 2013 to December 2017, 39 patients underwent preoperative US of the submandibular gland before submandibular surgery in our hospital. Among them, 9 were excluded because of inadequate histopathologic data (n = 7) or poor US image quality (n = 2). The US features of the resected submandibular glands were retrospectively investigated by a single radiologist, blinded to clinicoserological information and the histopathologic result, using a picture archiving and communication system. Histopathologic analysis of the submandibular gland was retrospectively performed by a single pathologist. After histopathologic analysis, 11 of the 30 patients were classified as DSD and 19 as NSP. Of the individual US features, only parenchymal echotexture exhibited a statistically significant difference between NSP and DSD (P < 0.0001), whereas the other US features showed no significant differences (P > 0.05). There was no significant relationship between diffuse fibrosis and glandular size (P = 0.310) or the other US features (P = 1.000). In conclusion, US may be helpful for differentiating incidental DSD from NSP.

In this study, we compared ultrasound (US) features between normal parotid parenchyma (NPP) and incidental diffuse parotid disease (DPD). From January 2008 to December 2017, 180 patients underwent neck US before parotid surgery at our hospital. From these, 82 were excluded because of the lack of histopathological data concerning the parotid parenchyma or inadequate US images. A single radiologist blinded to the clinicoserological data and histopathological results, retrospectively investigated all US features and categorizations for the parotid glands using a picture archiving and communication system. Retrospective histopathological analysis of the parotid parenchyma was performed by a single pathologist. On the basis of the histopathological analyses, the 98 patients were divided into NPP (n = 70) and DPD (n = 28) groups. Among US features, parenchymal echogenicity and echotexture showed statistically significant differences between the two groups (p < 0.0001), whereas the gland size, margin, and vascularity showed no significant differences (p > 0.05). The US-based categorization significantly differentiated between NPP and DPD (p < 0.0001), and receiver operating characteristic curve analysis revealed that US categorization based on ≥2 abnormal US features showed the best diagnostic performance for detecting DPD. Thus, US can aid in differentiating DPD from NPP., Competing Interests: The authors have declared that no competing interests exist.

Objective: The purpose of this multicenter study was to assess the diagnostic accuracy of real-time sonography (US) for differentiating diffuse thyroid disease (DTD) from normal thyroid parenchyma among radiologists blinded to patients' clinical, serologic, and imaging history and to determine the differences in diagnostic accuracy among radiologists from different institutions., Materials and Methods: From January to March 2017, 214 patients underwent preoperative thyroid US and subsequent thyroid surgery at four participating institutions. Real-time US was performed at each institution by an attending radiologist, who classified US diagnoses into one of the following four categories based on US findings: no DTD, indeterminate, suspicious for DTD, and DTD. The outcomes of US diagnoses were compared with histopathologic results to determine the diagnostic accuracy of real-time US at each institution., Results: Histopathologic results included normal thyroid parenchyma (n = 143), Hashimoto thyroiditis (n = 29), non-Hashimoto lymphocytic thyroiditis (n = 37), and diffuse hyperplasia (n = 5). Normal thyroid parenchyma and DTD exhibited statistically significant differences in echogenicity, echotexture, size, glandular margin, vascularity of thyroid, and US classification. There was positive correlation between US classification and histopathologic results at all institutions for detecting DTD. The highest diagnostic indexes were obtained when the cutoff criterion was suspicious for DTD. There was favorable diagnostic accuracy, with statistically significant differences, at all institutions for the diagnosis of DTD., Conclusion: Real-time US can be helpful for differentiating DTD from normal thyroid parenchyma.

Objective: The purpose of the present study is to assess the visibility of the normal appendix on CT, MRI, or ultrasound (US) images of a healthy population., Materials and Methods: The MEDLINE and EMBASE databases were searched to identify articles on the rates of detection of a normal appendix on CT, MRI, or US that appeared in the literature published up to January 20, 2017. Pooled detection rates were assessed using random-effects modeling, and rates associated with different imaging modalities were compared. Meta-regression analyses were performed to assess factors influencing detection rates and heterogeneity., Results: Thirty-two studies (21 CT studies with 5296 patients, 7 MRI studies with 600 patients, and 4 US studies with 1221 patients) were included in our meta-analysis. The overall normal appendix detection rate tended to be highest for CT (84%), followed by US (71%) and MR (69%), but no statistically significant differences were noted (for CT vs MRI, p = 0.16; for CT vs US, p = 0.23; and for MRI vs US, p = 0.91). Meta-regression analyses of the appendix detection rate with CT revealed that the year of publication of the study, the number of CT channels, and slice thickness affected study heterogeneity., Conclusion: Normal appendixes seemed to be more visible on CT than on MRI or US, although this finding did not have statistical significance. With respect to CT, detection of normal appendixes was significantly better when more channels and thinner slices were used.

Purpose: To compare the diagnostic performance of ultrasonography (US) and computed tomography (CT) for diagnosing incidentally detected diffuse thyroid disease (DTD) in patients who underwent thyroid surgery using multicenter data., Methods: Between July and December 2016, a total of 177 patients who underwent preoperative thyroid US and neck CT, and subsequent thyroid surgery at 4 participating institutions, were reviewed. US and CT images in each case were retrospectively reviewed by a radiologist at each institution, and classified into one of the following four categories based on US and CT features: no DTD; indeterminate; suspicious for DTD; and DTD. The diagnostic accuracy of US and CT were calculated at each institution by comparison with histopathological results., Results: Respective US and CT classifications in the 177 patients were no DTD in 75 and 71, indeterminate in 46 and 34, suspicious for DTD in 28 and 31, and DTD in 28 and 41. Among the histopathological results, 113 patients had normal thyroid parenchyma, 23 had Hashimoto thyroiditis, 36 had non-Hashimoto lymphocytic thyroiditis, and 5 had diffuse hyperplasia. The presence of ≥ 2 US and CT features of DTD, which was classified as suspicious for DTD or DTD, had the largest area under the receiver operating characteristic curve (0.866 and 0.893, respectively), with sensitivity and specificity of 71.9 and 91.2% in US, and 84.4 and 84.1% in CT, respectively. However, there was no statistically significant difference between readers' experience and their diagnostic performance., Conclusion: US and CT imaging may be helpful for detecting incidental DTD.

Objective: None of the previous studies have investigated the interval change in ultrasonography (US) features of solid thyroid nodules (STNs) after US-guided fine-needle aspiration (US-FNA). This study aimed to assess the prevalence and characteristics of US interval changes in STNs after US-FNA., Materials and Methods: This study included 257 STNs in 257 patients in whom thyroid US and initial US-FNA had been performed by two radiologists from January 2015 to June 2015. One of the radiologists performed single needle puncture in all cases, whereas the other radiologist used double or triple needle punctures. Follow-up US examinations were performed after 12.0 ± 6.0 months. We evaluated the prevalence and characteristics of post-FNA US interval changes through a retrospective analysis. In addition, multiple factors were correlated with post-FNA US interval changes., Results: The number of needle punctures was one (n = 91), two (n = 163), and three (n = 3). Of the 257 STNs (mean diameter, 11.9 mm) in 257 patients, 35 (13.6%) showed an interval change in US features on follow-up US. Among them, 17 STNs (6.6%) showed newly developed malignant US features, including hypoechogenicity (n = 5), microcalcifications (n = 2), a spiculated margin (n = 4), hypoechogenicity with a spiculated margin (n = 5), and microcalcifications with non-parallel orientation (n = 1). Between patients who showed presence and absence of US interval changes, there were no significant differences in patient age, sex, nodule size, dichotomization, and location, Korean Thyroid Imaging Reporting and Data System categorization after FNA, practitioners involved, number of needle punctures, cytological findings, and interval between FNA and US follow-up ( p > 0.05)., Conclusion: Awareness of US interval changes after US-FNA of STNs may be helpful for the management of STNs.

Objective: No previous prospective study has investigated the detection of normal parathyroid glands (PTGs) and their features using real-time ultrasound (US). This study aimed to assess the preoperative US detection of normal PTGs in patients who underwent hemithyroidectomy., Methods: Between August and October 2016, 44 patients underwent hemithyroidectomy using a low-collar incision, and 5 were excluded from the study. A single radiologist performed the preoperative US examination in all patients, and the surgical data for the PTGs were obtained by a single surgeon. Based on the surgical findings of PTGs, the preoperative US detection of PTGs was determined., Results: Of the 39 patients, 3 had no surgical data for PTG (n = 2) and the presence of parathyroid hyperplasia (n = 1). In the 36 remaining patients, in 3 patients, US identification of a normal PTG was corroborated by surgical findings, whereas in 2 patients, US findings differed from surgical findings, and in 31 patients, US did not detect a normal PTG. The successful US detection rate of normal PTG was only 8.3% (3/36)., Conclusions: US cannot be used for identification of normal PTGs.

Background The distally extended muscle belly of the flexor digitorum (MB-FD) within the carpal tunnel has been suggested as a plausible cause for carpal tunnel syndrome (CTS) based on cadaveric studies. Purpose To evaluate whether MB-FD within the carpal tunnel is a risk factor for CTS by comparing asymptomatic volunteers and patients with CTS. Material and Methods Presence, length, and cross-sectional area of MB-FD within the carpal tunnel were evaluated in 63 wrists of 32 asymptomatic volunteers and 52 wrists of 33 patients with CTS using ultrasonography. Length of MB-FD within the carpal tunnel was measured as the distance between the distal end of MB-FD and the palmar margin of the distal radius longitudinally. On a transverse scan, the cross-sectional area of MB-FD at the proximal limit of the carpal tunnel was measured. Results MB-FD in the carpal tunnel was found in 39 (62%) asymptomatic volunteers and 35 (67%) patients with CTS ( P = 0.549). There was a female preponderancy of MB-FD within the carpal tunnel in asymptomatic volunteers ( P = 0.044), but not in patients. Length and cross-sectional area of MB-FD within the carpal tunnel were significantly greater in male-CTS patients than in male volunteers ( P = 0.022 and 0.012, respectively). These qualities were risk factors for CTS in men, though not in women. Conclusion The presence of distally extended MB-FD within the carpal tunnel was not a risk factor for CTS. In men, a longer and thicker MB-FD within the carpal tunnel increased the risk for CTS.

Objective: This study aimed to evaluate the locoregional recurrence rate of follicular thyroid carcinoma (FTC) and to assess the appropriate frequency of postoperative ultrasonography (US) surveillance for detecting tumor recurrence., Methods: The review boards of the seven participating institutions approved this study. From 2000 to 2011, 186 patients underwent at postoperative US at least once; US was performed by experienced radiologists at each institution. Based on the US and histopathological results, locoregional tumor recurrence was assessed., Results: The T stages of the 186 patients were T1a (8.1%), T1b (21.5%), T2 (39.8%), T3 (30.6%), T4a (0%), and T4b (0%). The N stages were unknown (24.2%), N0 (71.5%), N1a (3.2%), and N1b (1.1%), and the M stages unknown (29.6%), M0 (66.1%), and M1 (4.3%). Tumors recurred in only 6 (3.2%) patients during the follow-up period over 5 years. Among them, no patients showed the initial suspicion of recurrences on routine follow-up US. The session number and interval of postoperative US differed significantly between patients with recurrence and those without recurrence. The mean interval of postoperative follow-up US at the first detection time of tumor recurrence was 37.5 ± 18.5 months (range 9-62 months). Significantly more FTCs were at an advanced N and M stage in the recurrence group than in the non-recurrence group (p < 0.05)., Conclusions: Routine postoperative US surveillance may be unnecessary for detecting tumor recurrence after thyroid surgery in FTC patients.

Objective: No previous study has investigated the ultrasonography (US) and cytopathological features of an inflammatory pseudonodule (IFP) associated with underlying thyroiditis. This study aimed to evaluate and identify the characteristic US features of IFP in patients who underwent US-guided fine-needle aspiration (US-FNA)., Methods: From January 2012 to December 2014, 899 patients underwent US-FNA for a solid thyroid nodule that was ≥5 mm in diameter, by a single radiologist. Among them, 49 nodules showed lymphocytic thyroiditis on cytological analysis. Based on cytohistopathological and follow-up US results, 28 IFP cases were included. The same radiologist and a cytopathologist retrospectively analyzed all the US images and the cytology slides, respectively., Results: The locations of 28 IFPs were from the right lobe (n = 13), left lobe (n = 13), and isthmus (n = 2). The echogenicity of 28 IFPs was hypoechoic (n = 5) or marked hypoechoic (n = 23). The common US features of IFP were marked hypoechogenicity, no calcification, smooth margin, ovoid shape, and the same vascularity as adjacent parenchyma. However, no IFP cases showed calcification, spiculated margin, taller-than-wide shape, and central or peripheral vascularity. The common cytopathological feature of IFP was lymphocyte infiltration, but the intensity of this was variable, with mild, moderate, and severe intensity observed in 8 (28.6%), 11 (39.2%), and 9 (32.1%) of cases, respectively., Conclusion: IFP rarely showed malignant US and cytopathological features, except for marked hypoechogenicity, and these findings may be helpful for US and cytopathological diagnoses. Diagn. Cytopathol. 2016;44:725-730. © 2016 Wiley Periodicals, Inc., (© 2016 Wiley Periodicals, Inc.)

Objective: To my knowledge, no previous study has evaluated the sonographic features of thyroidal fatty lesions. The present study aims to assess the features of thyroidal fatty lesions as seen on ultrasound images and to determine the frequency of such lesions., Materials and Methods: From January 2013 to December 2014, a total of 940 patients underwent preoperative ultrasound and CT examinations of the neck before undergoing thyroid surgery. The criterion for the diagnosis of thyroidal fatty lesions was the presence of intraglandular fatty tissue on CT images, regardless of lesion size. One radiologist retrospectively analyzed all the ultrasound and CT images of these patients., Results: Of the 940 patients whose images were reviewed, 20 (2.1%) had thyroidal fatty lesions noted on neck CT and 17 of these 20 patients had thyroidal fatty lesions (mean of largest diameter, 6.3 mm; range, 4.8-9.2 mm) noted on ultrasound. The 20 involved sites included the right lobe (n = 11), the left lobe (n = 9), and the isthmus (n = 0). For 17 of these 20 cases (85%), continuity with the adjacent thyroid capsule or perithyroidal fatty tissue was seen on ultrasound or CT. All thyroidal fatty lesions showed hyperechogenicity, no calcification, no posterior shadowing or enhancement, and an ovoid shape, and most thyroidal fatty lesions had inhomogeneous echogenicity and a smooth margin., Conclusion: On ultrasound images, thyroidal fatty lesions characteristically appear as ovoid inhomogeneously hyperechoic thyroid nodules with no calcification, no posterior shadowing or enhancement, a smooth margin, and continuity with the adjacent thyroid capsule or perithyroidal fatty tissue.

Objectives: This study aimed to assess the sonographic characteristics and interval changes of subacute thyroiditis using follow-up sonography., Methods: From January 2008 to December 2014, 85 patients with clinically suspected subacute thyroiditis underwent sonographic examinations by a single radiologist. Subacute thyroiditis was confirmed on the basis of the clinical, sonographic, and cytohistopathologic findings. On the initial and follow-up sonograms, the individual sonographic findings and interval changes were retrospectively investigated by the same radiologist. According to the sonographic configuration, subacute thyroiditis lesions were categorized as nodular or non-nodular. The interval changes in the lesions were classified as follows: "disappeared," "decreased," "increased," "eventually smaller," "eventually larger," or "no interval change.", Results: Subacute thyroiditis was confirmed in 64 of the 85 patients. In these 64 patients, nodular (n = 39) and non-nodular (n = 35) lesions were found; 10 patients had both nodular and non-nodular lesions. Of the 64 patients, 41 underwent sonographic follow-up. In both nodular and non-nodular lesions, the common interval changes included disappeared, decreased, and eventually smaller patterns. Although the increased pattern was found only in 4 nodular lesions, there was no significant difference in the interval changes between nodular and non-nodular lesions. On follow-up sonography, a new lesion was detected in 6 patients., Conclusions: The prevalence rate of nodular subacute thyroiditis lesions on sonography was high, and the interval changes in the lesions were variable.

Objective: The aim of this study was to compare the diagnostic accuracy of real-time and static ultrasonography (US) for the incidental detection of diffuse thyroid disease (DTD)., Methods: In 118 consecutive patients, a single radiologist performed real-time US before thyroidectomy. For static US, the same radiologist retrospectively investigated the sonographic findings on a picture-archiving and communication system after 3 months. The diagnostic categories of both real-time and static US diagnoses were determined based on the number of abnormal findings, and the diagnostic indices were calculated by a receiver operating characteristic (ROC) curve analysis using the histopathologic results as the reference standard., Results: Histopathologic results included normal thyroid (n = 77), Hashimoto thyroiditis (n = 11), non-Hashimoto lymphocytic thyroiditis (n = 29), and diffuse hyperplasia (n = 1). Normal thyroid and DTD showed significant differences in echogenicity, echotexture, glandular margin, and vascularity on both real-time and static US. There was a positive correlation between US categories and histopathologic results in both real-time and static US. The highest diagnostic indices were obtained when the cutoff criteria of real-time and static US diagnoses were chosen as indeterminate and suspicious for DTD, respectively. The ROC curve analysis showed that real-time US was superior to static US in diagnostic accuracy., Conclusion: Both real-time and static US may be helpful for the detection of incidental DTD, but real-time US is superior to static US for detecting incidental DTD.

Objectives: We aimed to assess the usefulness of sonographically based diagnosis to predict whether contralaterally located dominant thyroid nodules are malignant or benign in patients with known papillary thyroid microcarcinoma., Methods: We studied 143 patients with primary papillary thyroid microcarcinoma who underwent preoperative thyroid sonography. Each dominant thyroid nodule was prospectively classified into 1 of 5 diagnostic categories by a single radiologist: benign, probably benign, borderline, possibly malignant, and malignant. We calculated the efficacy of sonographic diagnosis for contralateral malignancy by using histopathologic or long-term sonographic follow-up results as reference standards., Results: Of the 143 primary papillary thyroid microcarcinomas, 17 showed satellite carcinomas; hence, the bilaterality rate in all patients was 11.9% (17 of 143). Real-time sonography of the contralateral thyroid yielded no thyroid nodules (n = 55) and benign (n = 52), probably benign (n = 10), borderline (n = 13), possibly malignant (n = 4), and malignant (n = 9) nodules. When the borderline sonographic class was excluded, the sensitivity, specificity, positive and negative predictive values, and accuracy of sonographic diagnosis for detecting contralateral malignancy were 86.7%, 100%, 100%, 98.3%, and 98.5%, respectively. Within individual sonographic classes for the dominant thyroid nodules, the diagnostic accuracy rates for classes IV and V (possibly malignant and malignant) were higher than those for other classes., Conclusions: Sonographically based diagnosis may be helpful for detection of contralateral malignancy in preoperative patients with papillary thyroid microcarcinoma., (© 2015 by the American Institute of Ultrasound in Medicine.)

The aim of this study was to assess the accuracy of ultrasound (US) and individual US features in the diagnosis of nodal metastasis in patients with papillary thyroid carcinoma (PTC) with respect to nodal compartment. US diagnoses and individual US features of nodal metastases with respect to nodal compartment were investigated in 184 consecutive PTC patients who underwent pre-operative US. Histopathologic results were used as a reference standard. One hundred thirty-six of 368 (37.0%) central compartments contained one or more metastatic nodes, whereas 44 of 48 (91.7%) lateral compartments had one or more metastatic nodes. The malignancy rates of suspicious US diagnoses in the central and lateral compartments were 66.3% (53/80) and 93.3% (42/45), respectively. The central and lateral compartments differed significantly in nodal composition, echogenicity, calcification, shape, hilar echogenicity and vascularity. The accuracy of US in the diagnosis of nodal metastases from PTC was lower in the central compartment than in the lateral compartment., (Copyright © 2015 World Federation for Ultrasound in Medicine & Biology. Published by Elsevier Inc. All rights reserved.)

Objective: The prevalence and features of the thyroid pyramidal lobe (TPL) on computed tomography (CT) have been reported, but no ultrasound (US) study has been found. The purposes of the current study were to assess the sonographic prevalence and features of TPLs and to compare the US and CT parameters of TPLs., Methods: From November 2012 to February 2013, a total of 160 patients who were scheduled for surgical treatment of thyroid cancers and follicular neoplasms were enrolled. A single radiologist prospectively evaluated the presence and features of TPLs on preoperative thyroid US, noting the size, location, degree of continuity with the main thyroid gland, and superior extent of each TPL. On a different day, the same radiologist retrospectively evaluated CT findings in the same patients from a picture archiving and communication system., Results: Ultrasound revealed TPLs in 82 cases (50.6%) and CT revealed TPLs in 96 cases (59.3%). Thyroid pyramidal lobes predominantly originated from the left thyroid lobe on both US (34/82, 41.5%) and CT (40/96, 41.7%). The mean length, anteroposterior diameter, transverse diameter, and volume of the TPLs were 20.9 mm, 2.0 mm, 5.8 mm, and 268.6 mm on US and 22.8 mm, 1.9 mm, 6.1 mm, and 344.0 mm on CT, respectively. When CT findings were used as the reference standard, the sensitivity, specificity, positive and negative predictive values, as well as accuracy of US for detecting TPLs were 82.3, 95.3, 93.3, 78.2, and 87.5%, respectively., Conclusions: Like neck CT, thyroid US may be useful in evaluating TPLs.

Objectives: This study aimed to assess the rate of preoperative sonographic detection of thyroid pyramidal lobes with subsequent surgical findings as the reference standard., Methods: From January 2013 to March 2013, a single radiologist prospectively performed thyroid sonography to detect thyroid pyramidal lobes in consecutive patients who were scheduled for thyroid surgery on the same day. The location, anteroposterior and transverse diameters, length, and location of the upper end of each thyroid pyramidal lobe and its separation or contiguity with the main thyroid gland were investigated by thyroid sonography and surgery., Results: The types of thyroid surgery included total thyroidectomy (n = 85), subtotal thyroidectomy (n = 4), and hemithyroidectomy (n = 43). The surgical incidence of thyroid pyramidal lobes was 59.8% (79 of 132), and the sensitivity, specificity, positive and negative predictive values, and accuracy of sonography for detection of thyroid pyramidal lobes were 81.0%, 79.2%, 85.3%, 73.7%, and 80.3%, respectively. The mean values for the anteroposterior diameter, transverse diameter, and length of the 79 thyroid pyramidal lobes at surgery were 2.2, 6.2, and 26.5 mm, respectively, but these measurements did not show statistically significant correlations with the sonographic detection rate of thyroid pyramidal lobes., Conclusions: Our study indicates that thyroid sonography may be helpful for identifying the presence and location of thyroid pyramidal lobes.

The aim of this study was to assess the efficacy of, both individually and in combination, ultrasound (US) diagnosis, US-guided fine-needle aspiration (US-FNA) and polymerase chain reaction (PCR) in diagnosing tuberculous lymph nodes in the neck (i.e., tuberculous cervical lymph nodes [TCLs]). Eighty-two patients who underwent US diagnosis, US-FNA and PCR for clinical suspicion of TCLs were enrolled. Of the 82 patients, 31 were confirmed as having TCLs. The sensitivity, specificity, positive and negative predictive values and accuracy of US diagnosis, US-FNA and PCR were 93.5%, 76.5%, 70.7%, 95.1% and 82.9%; 64.5%, 98.0%, 95.2%, 82.0% and 85.4%; and 100%, 96.1%, 93.9%, 100% and 97.6%, respectively. The diagnostic values of PCR alone and in combination with US-FNA were found to be higher than those of other methods. No US feature with high sensitivity and specificity was identified., (Copyright © 2013 World Federation for Ultrasound in Medicine & Biology. Published by Elsevier Inc. All rights reserved.)

This study was aimed at assessing the efficacy of using an ultrasound (US)-based classification system to diagnose solid thyroid nodules with the largest diameter <5 mm (i.e., small solid nodules). For 406 small solid nodules in 365 patients who underwent thyroid US and US-guided fine-needle aspiration, each thyroid nodule was prospectively classified into one of five diagnostic categories: benign, probably benign, borderline, possibly malignant and malignant. Of 406 nodules, 145 were surgically removed: 95 papillary thyroid carcinomas, 1 follicular thyroid carcinoma, 1 poorly differentiated carcinoma, 3 pseudonodules related to thyroiditis and 45 nodular hyperplasias. On the basis of the histopathologic results, the diagnostic accuracies of US diagnosis and cytologic diagnosis were similar, but the sensitivity of US diagnosis was higher than that of cytologic diagnosis, and the specificity and positive predictive values of US diagnosis were lower those of cytologic diagnosis. An US-based classification system may be helpful for the diagnosis and management of small solid nodules., (Copyright © 2013 World Federation for Ultrasound in Medicine & Biology. Published by Elsevier Inc. All rights reserved.)

Objective: The purpose of this study was to analyze statistically significant diagnostic factors for pilomatricoma on the basis of ultrasonographic features., Methods: Sonographic images were retrospectively reviewed from 44 pilomatricomas, and from 43 control subjects with other subcutaneous tumors. Two radiologists determined the tumoral shape, margin, echotexture, echogenicity, posterior shadowing, posterior enhancement, hypoechoic rim, internal calcification, and vascularity., Results: The reliable diagnostic factors for pilomatricoma were hypoechogenicity (P < 0.001), heterogenicity (P < 0.05), internal calcification (P < 0.001), hypoechoic rim (P < 0.001), and posterior shadowing (P < 0.001). Scattered dots were the most common patterns of internal calcification. A combination of hypoechogenicity, heterogenicity, internal calcification of scattered-dot pattern, and a hypoechoic rim was a statistically significant difference between the two groups (P < 0.001; odds ratio, 21)., Conclusions: The features of heterogeneous echotexture, internal echogenic foci in scattered-dot pattern, and a hypoechoic rim or posterior shadowing itself could be discriminative ultrasonographic criteria for differentiating pilomatricomas from other subcutaneous tumors.

Background: The objective of this study was to compare the efficacy and procedure time of ultrasound-guided fine-needle aspiration biopsy (US-FNAB) of thyroid nodules, according to the nodule size., Methods: US-FNABs of thyroid nodules performed between June 2007 and December 2007 were studied. We divided these patients into three groups according to the largest diameter of their nodules. Group A consisted of patients with thyroid nodules less than or equal to 5 mm, group B of patients with thyroid nodules greater than 5 mm and less than or equal to 10 mm, and group C of patients with thyroid nodules greater than 10 mm. We retrospectively reviewed the cytopathology results and complications in all three patient groups and measured the separate, total US-FNAB procedure time for each of 20 randomly selected thyroid nodules., Results: US-FNAB was performed on 438 thyroid nodules in 253 patients. In groups A, B, and C, the adequacy rates from the first US-FNAB were 79.6% (90/113), 90.6% (125/138), and 95.2% (178/187), respectively. In groups A, B, and C, 113, 138, and 187 thyroid nodules in 100, 120, and 169 patients, respectively, revealed 59, 75, and 126 benign; 12, 11, and 9 suspicious for malignancy; 9, 32, and 29 malignant; 10, 7, and 14 inderminate for malignancy; and 23, 13, and 9 inadequate on the first US-FNAB. The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy were determined to be 85.7%, 100%, 100%, 94.9%, and 96.1% in group A; 97.7%, 100%, 100%, 98.7%, and 99.1% in group B; and 100%, 99.2%, 97.1%, 100%, and 99.4% in group C. The mean procedure times in groups A, B, and C were 2 minutes 33 seconds, 1 minute 50 seconds, and 1 minute 32 seconds, respectively. There were no significant patient complications in any of the three patient groups., Conclusions: US-FNAB of thyroid nodules smaller than 5 mm in maximum diameter was less successful, and the sensitivity was lower than those of nodules larger than 5 mm. We considered, however, that the sampling adequacy and efficacy of US-FNAB of thyroid nodules less than 5 mm in maximum diameter was satisfactory in our series and should be similar in other centers with similar characteristics to ours.

Objective: The relationship between radioactive iodine therapy (RIT) and prevalence of thyroglossal duct cysts (TGDC) on ultrasonography (US) has not been reported. We assessed the prevalence and US features of TGDC according to RIT. Methods: From July 2017 to June 2018, 3,146 subjects underwent thyroid or neck US at our center. The presence or absence of TGDCs was prospectively investigated based on real-time US examination. Among the 3,146 subjects, 261 subjects were excluded because of <18 years of age, unclear information of RIT, or the presence of a radiation therapy history to the neck. Eventually, 2,885 subjects were included in this study. Results: Of the 2,885 subjects finally included, 126 (4.4%) showed a TGDC on US. Those with RIT history showed a higher prevalence of TGDCs than those without (no statistical difference, p = 0.062). In 697 male subjects, there were statistical differences in type of surgery, RIT history, and session number of RIT between those with or without TGDCs (p < 0.0001). In 126 subjects with TGDCs, only sex showed a significant difference between those with or without RIT history (p = 0.015). However, there were no significant differences in the location, size, and shape of TGDCs (p > 0.05). The common US features of TGDC were suprahyoid location, ~1 centimeter, and flat-to-ovoid or round shape. Conclusions: RIT may increase the prevalence of TGDCs, particularly in men. [ABSTRACT FROM AUTHOR]

Background: Benign thyroid follicular tumors without histological evidence of carcinoma can metastasize. However, the pathogenesis of metastasis remains unclear. Here, the new proposed terminology, "non-invasive follicular thyroid neoplasm with papillary-like nuclear features" should be considered. We present a case of an encapsulated type of follicular variant of papillary thyroid carcinoma (FVPTC) that exhibited distant lung and brain metastases and was initially diagnosed as follicular adenoma. Case Report: In December 2006, a 64-year-old woman underwent ultrasonography-guided fine-needle aspiration of the right thyroid nodule at our hospital because of a palpable right neck mass. Right lobectomy was performed, and a follicular adenoma was diagnosed. In October 2015, she visited our hospital owing to dry cough and mild dyspnea and underwent computed tomography-guided transthoracic core needle biopsy for the lung nodule owing to probably multiple lung metastasis on chest X-ray and computed tomography. Based on retrospective analysis of the primary thyroid tumor and lung nodule specimen, an encapsulated follicular variant of papillary thyroid carcinoma with lung metastasis was confirmed. Conclusion: We report a case of an encapsulated follicular variant of papillary thyroid carcinoma with unexpected metastasis to the lung 9 years after thyroid surgery in a patient who was initially diagnosed as follicular adenoma. A careful close follow-up with re-examination of the histopathology specimen may be needed in patients who were diagnosed with benign thyroid follicular tumors. [ABSTRACT FROM AUTHOR]

Objective: This study aimed to compare the ultrasonography (US) features of diffuse thyroid disease (DTD) and normal thyroid parenchyma (NTP), and to propose a structured imaging reporting system for detecting DTD. Methods: This retrospective study assessed the findings for 270 consecutive patients who underwent thyroid US before thyroid surgery. The following US data were analyzed: DTD-specific features, parenchymal echotexture and echogenicity, anteroposterior diameter, glandular margin, and parenchymal vascularity. Univariate and multivariate analyses with generalized estimating equations were performed to investigate the relationship between US features and DTD. The fitted probability of DTD was analyzed by using a regression equation. Results: Of the 270 patients, there were NTP (n = 193), Hashimoto thyroiditis (n = 24), non-Hashimoto lymphocytic thyroiditis (n = 51), Graves' disease (n = 1), and diffuse hyperplasia (n = 1). The following US features were significantly associated with DTD: decreased or increased parenchymal echogenicity, coarse parenchymal echotexture, increased anteroposterior diameter, lobulated glandular margin, and increased parenchymal vascularity. Of these, coarse parenchymal echotexture was the most significant independent predictor of DTD. The numbers of abnormal US features were positively correlated with the fitted probability and risk of DTD. The diagnostic indices were highest when the chosen cut-off criterion was category III with the largest Az value (0.867, 95% confidence interval: 0.820–0.905), yielding a sensitivity of 68.8%, specificity of 92.2%, positive predictive value of 77.9%, negative predictive value of 88.1%, and accuracy of 85.6% (p < 0.001). Conclusions: Our sonographic reporting and data system may be useful for detecting DTD. [ABSTRACT FROM AUTHOR]

Objective: This study aimed to evaluate the ultrasonography (US), cytology, and thyroglobulin (Tg) measurement results of nodal metastasis in patients showing unclear US or cytology results of primary papillary thyroid carcinoma (PTC). Methods: From January 2016 to December 2018, 179 patients underwent US-guided fine-needle aspiration (FNA) to diagnose lymphadenopathy in the neck. Among them, 36 patients underwent subsequent total thyroidectomy and nodal dissection, and cervical lymph node (LN) metastasis from PTC was confirmed. However, two patients were excluded because of mismatch between the US and pathological findings of LNs. US images and cytological slides for metastatic LNs were retrospectively analyzed, and serum and FNA Tg levels for metastatic LNs were investigated using data from the electric medical records. Primary PTC patients with suspicious results on both US and cytology were classified as the clear group, and the remaining patients were classified as the unclear group. Results: Of the 34 patients, 24 had clear results of primary PTC on both US and cytology (clear group), whereas 10 had unclear results of primary PTC on US or cytology (unclear group). Of the 10 patients in the unclear group, seven had suspicious nodal metastasis from PTC on cytology after US-guided FNA of the cervical LN, and the remaining three had negative cytology but a positive Tg measurement. Metastatic LNs with cystic change tended to show a positive Tg measurement but negative cytology. Conclusions: The combination of US, cytology, and Tg measurement is necessary for diagnosing nodal metastasis from PTC. In cases with unclear primary PTC on US or cytology, the detection of nodal metastasis may be helpful for assessing primary PTC. [ABSTRACT FROM AUTHOR]

Amyloid goiter (AG) is defined as the diffuse enlargement of the thyroid gland resulting from extensive amyloid deposition. Imaging findings in AG may vary depending on the amount of amyloid and fat deposition. A few case reports of AG with clinically subacute thyroiditis (SAT)-like syndrome have been published. However, there have been no reports on AG mimicking SAT with clinical and imaging findings. Herein, we present a case of AG mimicking SAT with a detailed report of the clinical and imaging findings. [ABSTRACT FROM AUTHOR]

Background: The ultrasonographic characteristics and difference for various subtypes of papillary thyroid carcinoma (PTC) are still unclear. The aim of this study was to compare the ultrasonographic features of PTC according to its subtype in patients undergoing thyroid surgery. Methods: In total, 140 patients who underwent preoperative thyroid ultrasonography (US) and thyroid surgery between January 2016 and December 2016 were included. The ultrasonographic features and the Korean Thyroid Imaging Reporting and Data System (K-TIRADS) category of each thyroid nodule were retrospectively evaluated by a single radiologist, and differences in ultrasonographic features according to the PTC subtype were assessed. Results: According to histopathological analyses, there were 97 classic PTCs (62.2%), 34 follicular variants (21.8%), 5 tall cell variants (3.2%), 2 oncocytic variants (1.3%), 1 Warthin-like variant (0.6%), and 1 diffuse sclerosing variant (0.6%). Most PTCs were classified under K-TIRADS category 5. Among the ultrasonographic features, the nodule margin and the presence of calcification were significantly different among the PTC subtypes. A spiculated/microlobulated margin was the most common type of margin, regardless of the PTC subtype. In particular, all tall cell variants exhibited a spiculated/microlobulated margin. The classic PTC group exhibited the highest prevalence of intranodular calcification, with microcalcification being the most common. The prevalence of multiplicity and nodal metastasis was high in the tall cell variant group. Conclusion: The majority of PTCs in the present study belonged to K-TIRADS category 5, regardless of the subtype. Our findings suggest that ultrasonographic features are not useful for distinguishing PTC subtypes. [ABSTRACT FROM AUTHOR]

Purpose: The effect of ultrasonography (US)-guided fine-needle aspiration (US-FNA) for the collapse of benign cystic thyroid nodules is still unclear. This study aimed to assess the positive response rate following US-FNA of the cystic component of thyroid cysts and of partially cystic thyroid nodules (PCTNs), and to evaluate the factors influencing the outcome. Methods: From June to December 2013, seven radiologists at seven institutions prospectively performed US-FNA on 320 cystic thyroid nodules in 320 patients. Among them, 179 underwent at least one follow-up US examination following US-FNA of the cystic component at each institution by the same radiologist. A variety of factors, including US features of cystic thyroid nodules, the characteristics of the aspirates, and the follow-up US findings, were analyzed. Results: Of 179 cystic thyroid nodules, there were 53 thyroid cysts and 126 PCTNs. Of 179 cystic thyroid nodules, no malignancies were detected. On follow-up US, the mean size reduction rate of the cystic component was 31.9%, and 102 out of 179 thyroid nodules (57.0%) were assigned to the response group. On univariate analysis, the degree of aspiration and time interval between US-FNA and the final follow-up US showed the significant differences between the response and no response groups. On multivariate analysis, the only factor that influenced the outcome was the nodule type. The cystic component’s positive response rate after simple aspiration was higher in the thyroid cysts than in the PCTNs. Conclusions: US-FNA may be effective at collapsing the cystic components of benign thyroid cysts and PCTNs. [ABSTRACT FROM AUTHOR]

Background: For detecting tumor recurrence of medullary thyroid carcinoma (MTC) in the neck, an appropriate frequency and interval of postoperative ultrasonography (US) surveillance remains unclear. This study aimed to assess an appropriate interval and frequency of postoperative neck US surveillance for detecting tumor recurrence in patients who had undergone thyroid surgery due to MTC. Methods: A total of 86 patients who had undergone thyroid surgery for the treatment of MTC and had at least one postoperative US follow-up examination at any of nine affiliated hospitals were included. Postoperative follow-up US, clinical, and histopathological results of patients were reviewed. The tumor recurrence/persistence rate of MTC was investigated, and the interval and session number of postoperative follow-up US and clinicopathologic factors were compared between tumor recurrence/persistence and non-recurrence groups. Results: Of the 86 patients, 22 (25.6%) showed tumor recurrence/persistence. Of the 22 patients with tumor recurrence/persistence, 11 (50%) showed structural recurrence/persistence in the neck on follow-up US. In these 11 patients, the mean interval and session number of postoperative follow-up US between initial surgery and the first US detection of recurrence/persistence was 41.3 ± 39.3 months (range, 6-128 months) and 2.6 ± 2.3 (range, 1-8), respectively. On follow-up US, 6 (54.5%, 6/11) were diagnosed with tumor recurrence/persistence within 3 years of the initial surgery. Tumor recurrence/persistence was significantly correlated with TNM stage (p < 0.001) and multiplicity/bilaterality (p = 0.013). Conclusion: For detecting MTC recurrence/persistence, postoperative US surveillance at 1-year intervals may be sufficient within the first 3 years after thyroid surgery, but depending on the presence of relevant risk factors, annual or biannual US surveillance may be recommendable for 4-10 years after thyroid surgery. [ABSTRACT FROM AUTHOR]

Background: No previous study has employed the frequency and interval of follow-up ultrasonography (US) during the first 10 years after total thyroidectomy in patients with papillary thyroid carcinoma (PTC). The aim of this study was to determine the appropriate frequency and interval of follow-up US during the first 10 years in patients who have undergone total thyroidectomy for PTC. Methods: Two hundred seventy-two patients underwent total thyroidectomy for PTC at our institution from January 2006 to December 2007. Nineteen patients were excluded because of lack of US follow-up data for the neck. Follow-up US was performed by one of two radiologists in all patients. Tumor recurrence/persistence was confirmed by histopathology. Results: The mean interval between surgery and the final follow-up US examination was 79.0 months, and the mean number of follow-up US sessions was 5.9 in the 253 evaluable patients. Eleven patients (4.3%) developed tumor recurrence/persistence, which was detected on follow-up US within 5 years after total thyroidectomy in all cases. T and N stages were independently associated with tumor recurrence/persistence. The interval between surgery and first suspicion of tumor recurrence/persistence on follow-up US was ≤12 months in six patients and 20, 35, 41, 53, and 60 months in the remaining five patients. Conclusion: For detection of tumor recurrence/persistence after total thyroidectomy in patients with PTC, one or two sessions of follow-up US during the first 2 years, depending on T and N stages and one session of follow-up US in every second year during the following 8 years may be appropriate. [ABSTRACT FROM AUTHOR]

Background In papillary thyroid carcinoma (PTC) patients, postoperative ultrasonography (US) surveillance is recommended at intervals of six or 12 months even though evidence is weak. Purpose To determine the optimal interval of postoperative US surveillance in patients after total thyroidectomy for the treatment of PTC using multicenter data. Material and Methods A total of 1400 patients from seven tertiary hospitals who underwent total thyroidectomy for treatment of PTC were included. Based on a retrospective review of clinical and pathologic results, multiple factors were analyzed according to recurrence/persistence or no recurrence/persistence. In recurrence/persistence group, the interval and number of follow-up US sessions in the initial detection of recurrence/persistence were investigated. Results Of the 1400 patients, 115 (8.2%) showed tumor recurrence/persistence on follow-up US. Of 115 recurrence/persistence cases, 89 (77.4%) were initially detected on US: nodal recurrence/persistence (n = 92), non-nodal recurrence/persistence (n = 22), and both (n = 1). Among the clinical and pathologic factors, only tumor size and N stage were significant predictors for recurrence/persistence. In the recurrence/persistence group, the mean interval and number of follow-up US sessions in the initial detection of recurrence/persistence was 22.3 ± 16.8 months and 2.2 ± 1.9, respectively. Approximately two-thirds of recurrence/persistence cases (76/115, 66.1%) were detected in follow-up US within two years after total thyroidectomy. Conclusion In PTC patients after total thyroidectomy, the optimal interval of the first US follow-up may be one to two years after thyroid surgery, and the appropriate number of postoperative US surveillance sessions within the first five years may be only one or two. [ABSTRACT FROM AUTHOR]

Purpose:This study aimed to assess the prevalence of tumor recurrence and to determine the appropriate interval of follow-up ultrasonography (US) in papillary thyroid microcarcinoma (PTMC) patients who underwent lobectomy.Methods:Between January and December 2006, 137 patients underwent a lobectomy for the treatment of PTMC and at least one postoperative US follow-up examination. The postoperative follow-up US was performed by a single radiologist for all patients. Based on the follow-up US and histopathological results, tumor recurrence and nodal metastasis were determined.Results:In the 137 patients, the following diagnoses were made after lobectomy: intraglandular PTMC (n= 104), focally perithyroidal PTMC invasion within surgical margins (n= 18), nodal metastasis to the ipsilateral level VI node (n= 20), and satellite PTMC (n= 7). The patients showed differences in the number of post-operative follow-up US sessions and in the intervals of those sessions. Of the 137 patients, 135 (98.5%) exhibited no tumor recurrence on the follow-up US, whereas 2 (1.5%) exhibited tumor recurrence in the remnant thyroid gland. In these two patients with tumor recurrence, suspicious thyroid nodules were detected at the 96- and 90-month follow-up US, respectively.Conclusions:In this study, the PTMC tumor recurrence rate was low, indicating that early post-lobectomy follow-up US in short intervals is not beneficial for detecting PTMC recurrence. [ABSTRACT FROM AUTHOR]

Purpose No previous study using follow-up ultrasonography for evaluating the factors associated with the successful regression of congenital muscular torticollis in young infants has been published. This study aimed to assess clinical factors and sonographic features potentially influencing regression in patients with congenital muscular torticollis. Methods From January 2010 to December 2012, 80 infants underwent neck ultrasonography because of clinical suspicion of congenital muscular torticollis. We statistically analysed the correlation between complete resolution and clinicosonographic findings when complete resolution was defined as no visible lesion on follow-up ultrasonography. Results Of the 80 infants, 61 had congenital muscular torticollis and all were followed up by ultrasonography: 1) 34 underwent physiotherapy, and 27 of them (79.4%) revealed complete resolution in follow-up; 2) 27 did not undergo physiotherapy, and 15 of them (55.6%) showed complete resolution. A statistically significant correlation was found between physiotherapy and complete resolution, but not between complete resolution and patient sex; size, volume, and echogenicity of the lesion; and thickness ratio. Conclusions Physiotherapy was the only factor influencing complete resolution in young infants with congenital muscular torticollis. [ABSTRACT FROM AUTHOR]

The aim of this study was to evaluate the ultrasonographic features of the major salivary glands (MSGs) after post-operative radioactive iodine ablation (RIA) in patients with papillary thyroid carcinoma (PTC). The study population comprised 202 consecutively registered PTC patients who had undergone total thyroidectomy, RIA and follow-up neck ultrasonography. The ultrasonographic features of the MSGs in each patient were retrospectively evaluated by a single radiologist, and the presence of post-RIA changes was determined by direct comparisons of pre- and post-RIA follow-up ultrasonographic scans. Of the 202 patients, 94 (46.5%) had post-RIA changes in the MSGs on follow-up ultrasonography. RIA dose was closely associated with the prevalence of post-RIA changes. Post-RIA changes were more common in the parotid glands (n = 93, 46.0%) than in the submandibular glands (n = 7, 3.5%). Common ultrasonographic findings representing post-RIA changes in MSGs included coarse echotexture, decreased echogenicity, lobulated margin and decreased gland size. [ABSTRACT FROM AUTHOR]

In this study, we aimed to develop a new automated method for kidney volume measurement in children using ultrasonography (US) with image pre-processing and hybrid learning and to formulate an equation to calculate the expected kidney volume. The volumes of 282 kidneys (141 subjects, <19 years old) with normal function and structure were measured using US. The volumes of 58 kidneys in 29 subjects who underwent US and computed tomography (CT) were determined by image segmentation and compared to those calculated by the conventional ellipsoidal method and CT using intraclass correlation coefficients (ICCs). An expected kidney volume equation was developed using multivariate regression analysis. Manual image segmentation was automated using hybrid learning to calculate the kidney volume. The ICCs for volume determined by image segmentation and ellipsoidal method were significantly different, while that for volume calculated by hybrid learning was significantly higher than that for ellipsoidal method. Volume determined by image segmentation was significantly correlated with weight, body surface area, and height. Expected kidney volume was calculated as (2.22 × weight (kg) + 0.252 × height (cm) + 5.138). This method will be valuable in establishing an age-matched normal kidney growth chart through the accumulation and analysis of large-scale data. [ABSTRACT FROM AUTHOR]

Purpose To investigate the meaning of ureter dilatation during ultrasonography (US) in infants for evaluating vesicoureteral reflux (VUR). Materials and methods We retrospectively reviewed abdominal US images of infants who were diagnosed with urinary tract infection (UTI group) or only hydronephrosis without UTI (control group). Hydronephrosis (graded 0–4) and ureter dilatation (present or absent) were evaluated on each side with US. Voiding cystourethrography (VCUG) within 3 months time interval with US was also reviewed and VUR was graded (0–5) on each side. Hydronephrosis, ureter dilatation, and VUR were then compared between the two groups. Results Four hundred and three infants (142 in the UTI group and 261 in the control group) were included and VCUG was performed in 129 infants (68 in UTI and 61 in control groups). VUR grades were not different between the two groups ( p = 0.252). Hydronephrosis grade was not related to VUR in either group ( p > 0.05). However, ureter dilatation had a significant relationship with VUR in the UTI group ( p = 0.015), even among patients with a high-grade VUR ( p = 0.005). Whereas, ureter dilatation was not associated with VUR in the control group ( p = 0.744). The relationship between ureter dilatation and VUR was different between the two groups for both all grades ( p = 0.014) and high-grade ( p = 0.004) VUR. Ureter dilatation had 66.7% sensitivity, 80.3% specificity, and 79.4% accuracy for evaluating high-grade VUR in the UTI group. Conclusion Ureter dilatation on US can be a helpful finding for detecting VUR in infants with UTI, but not infants without UTI. [ABSTRACT FROM AUTHOR]