Peculiarities of sonoelastographic imaging of thyroid papillary cancer in presence of autoimmune thyroiditis
- Authors: Khachatryan A.R.1, Vardanyan G.J.2, Avetisyan G.A.2, Chomoyan A.S.3, Baghdasaryan S.E.2, Porksheyan K.A.2
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Affiliations:
- Medical Center “Dialab”
- Mkhitar Heratsi Yerevan State Medical University
- Medical Center “Nairi”
- Issue: Vol 93, No 4 (2021)
- Pages: 369-375
- Section: Original articles
- URL: https://journals.rcsi.science/0040-3660/article/view/71158
- DOI: https://doi.org/10.26442/00403660.2021.04.200675
- ID: 71158
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Abstract
Aim. To determine the features of visualization of papillar thyroid cancer (PTC) in presence of autoimmune thyroiditis (AIT) according to sonoelastography data.
Materials and methods. 155 patients were examined (75 – PTC, 30 – AIT, 20 – PTC in presence of AIT and 30 – with diffuse parenchymal changes) and 30 patients of the control group. Among patients with PTC 68 (90.7%) were represented by female (mean age 46.7±13.12 years) and 7 (9.3%) – by male (average age – 48.1±4.05 years) patients, PTC in presence of AIT – by 19 female (average age 46.9±16.98 years) and 1 male (22 years) patients. Ultrasound investigation was performed with devices Toshiba Aplio-400 and Toshiba Aplio-500 (Japan) by the standard method and using elastography. A surface transducer with a frequency of 10–14 MHz was used. An analysis of the thyroid ultrasound image was performed in correspondence with TI-RADS. For a qualitative assessment of the elastographic picture of thyroid foci, the Tsukuba–Ueno assessment visual standardized system was implemented.
Results. According to the TI-RADS scale, most nodular formations are assigned to category 4. With TPC with an unchanged thyroid gland, category 4 was determined in 52 patients (69.3%), and with PR in presence of AIT – 15 patients (75%). When determining the qualitative criteria for Tsukuba – Ueno, the majority of tumors were assigned to types 3b and 4: cancers in presence of AIT – 95% and cancers with no changes to thyroid gland – 81.3%. Sonoelastographic criteria for thyroid parenchyma with AIT with a high degree of confidence are significantly higher than in the control group (p<0.000). In a comparative analysis of thyroid sonoelastography in PTC with unchanged parenchyma and AIT, changes according to compression elastography are statistically unreliable. In shear wave elastography, sonoelastographic criteria for PTC are significantly higher in patients with AIT (p<0.02 when measured in kPa, p<0.01 when measured in m/s).
Conclusion. Sonoelastography data can be used as additional criteria in the differential diagnosis of focal thyroid formations.
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##article.viewOnOriginalSite##About the authors
Anna R. Khachatryan
Medical Center “Dialab”
Email: g.vardanyan11@mail.ru
ORCID iD: 0000-0003-1865-4144
врач-радиолог МЦ «Диалаб»
Armenia, YerevanGoar J. Vardanyan
Mkhitar Heratsi Yerevan State Medical University
Author for correspondence.
Email: g.vardanyan11@mail.ru
ORCID iD: 0000-0002-1972-5373
д.м.н., проф. каф. лучевой диагностики ЕГМУ им. М. Гераци
Armenia, YerevanGarnik A. Avetisyan
Mkhitar Heratsi Yerevan State Medical University
Email: g.vardanyan11@mail.ru
ORCID iD: 0000-0001-8745-0060
к.м.н., доц., проректор по постдипломному и непрерывному образованию, зав. каф. лучевой диагностики ЕГМУ им. М. Гераци
Armenia, YerevanAram S. Chomoyan
Medical Center “Nairi”
Email: g.vardanyan11@mail.ru
ORCID iD: 0000-0001-9425-6733
эндокринный хирург
Armenia, YerevanSatenik E. Baghdasaryan
Mkhitar Heratsi Yerevan State Medical University
Email: g.vardanyan11@mail.ru
ORCID iD: 0000-0002-2632-9416
к.м.н., доц., рук. центра постдипломного и непрерывного образования, доц. каф. эндокринологии ЕГМУ им. М. Гераци
Armenia, YerevanKristina A. Porksheyan
Mkhitar Heratsi Yerevan State Medical University
Email: g.vardanyan11@mail.ru
ORCID iD: 0000-0002-7227-0320
к.м.н., преподаватель каф. лучевой диагностики ЕГМУ им. М. Гераци
Armenia, YerevanReferences
- Состояние онкологической помощи населению России в 2014 году. Под ред. А.Д. Каприна, В.В. Старинского, Г.В. Петровой. М.: МНИОИ им. П.А. Герцена – филиал ФГБУ «НМИРЦ» Минздрава России, 2015 [The state of cancer care in the population of Russia in 2014. Kaprin AD, Starinskii VV, Petrova GV (Eds.) Moscow: P.A. Gertsen MNIOI, 2015 (In Russ.)].
- Dean DS, Gharib H. Epidemiology of thyroid nodules. Best Pract Res Clin Endocrinol Metab. 2008;22(6):901-11. doi: 10.1016/j.beem.2008.09.019
- Gharib H, Papini E, Paschke R, et al. American Association of Clinical Endocrinologists, Associazione Medici Endocrinologi, and European Thyroid Association Medical Guidelines for Clinical Practice for the Diagnosis and Management of Thyroid Nodules. Endocr Pract. 2010;16(Suppl. 1):1-43. doi: 10.4158/10024.GL
- Дедов И.И. Российские клинические рекомендации. Эндокринология. Под ред. И.И. Дедова, Г.А. Мельниченко. М.: ГЭОТАР-Медиа, 2016. Режим доступа: http://www.rosmedlib.ru/book/ISBN9785970436837.html Ссылка активна на: 21.04.2021 [Dedov II. Russian clinical recommendations. Endocrinology. Dedov II, Melnichenko GA (Eds.) Moscow: GEOTAR-Media, 2016. Available at: http://www.rosmedlib.ru/book/ ISBN9785970436837. Accessed: 21.04.2021 (In Russ.)]
- Guth S, Theune U, Aberle J, et al. Very high prevalence of thyroid nodules detected by high frequency (13 MHz) ultrasound examination. Eur J Clin Invest. 2009;39(8):699-706. doi: 10.1111/j.1365-2362.2009.02162.x
- Cooper DS, Doherty GM, Haugen BR, et al. Revised American Thyroid Association management guidelines for patients with thyroid nodules and differentiated thyroid cancer. Thyroid. 2009;19(11):1167-214. doi: 10.1089/thy.2009.0110
- Ракитина Д.А., Беляев А.М., Раджабова З.А., и др. Оптимизация диагностических мероприятий и лечебной тактики при распространенном раке щитовидной железы. Современные проблемы науки и образования. 2016;6. Режим доступа: http://www.science-education.ru/ru/article/view?id=25875. Ссылка активна на: 21.04.2021 [Rakitin DA, Beliaev AM, Radzhabova ZA, et al. Оptimization of diagnostic measures and therapeutic tactics in the previous thyroid cancer. Modern problems of science and education. 2016;6. Available at: http://www.science-education.ru/ru/article/view?id=25875. Accessed: 21.04.2021 (In Russ.)].
- Nguyen QT, Lee EJ, Huang MG, et al. Diagnosis and treatment of patients with thyroid cancer. Am Health Drug Benefits. 2015;8(1):30-40.
- Siegel RL, Miller KD, Jemal A. Cancer statistics. 2015. CA Cancer J Clin. 2015;65(1):5-29. doi: 10.3322/caac.21254
- Guo A, Kaminoh Y, Forward T, et al. Fine needle aspiration of thyroid nodules using the Bethesda system for reporting thyroid cytopathology: an institutional experience in a rural setting. Int J Endocrinol. 2017;2017:9601735. doi: 10.1155/2017/9601735
- Ahn HS, Kim HJ, Kim KH, et al. Thyroid Cancer Screening in South Korea Increases Detection of Papillary Cancers with No Impact on Other Subtypes or Thyroid Cancer Mortality. Тhyroid. 2016;26(11):1535-40. doi: 10.1089/thy.2016.0075
- Nabhan F, Ringel MD. Thyroid nodules and cancer management guidelines: comparisons and controversies. Endocr Relat Cancer. 2017;24(2):R13-26. doi: 10.1530/ERC-16-0432
- Lin JD, Hsueh C, Huang BY. Papillary thyroid carcinoma with different histological patterns. Chang Gung Med J. 2011;34(1):23-34.
- Тимофеева Л.А., Алешина Т.Н. Диагностическая тактика при узловых образованиях щитовидной железы на основе системы TI-RADS. Acta Medica Eurasica. 2017;4:37-44 [Timofeeva LA, Aleshina TN Diagnostic tactics for nodular thyroid formations based on the TI-RADS system. Acta Medica Eurasica. 2017;4:37-44 (In Russ.)]. doi: 10.17750/KMJ2017-632
- Нечаева О.А., Бавыкина Л.Г., Глазков А.А., Бритвин Т.А. Опыт применения системы Bethesda в оценке результатов тонкоигольной аспирационной биопсии узловых образований щитовидной железы. РМЖ. 2018;1(1):23-7 [Nechaeva OA, Bavykina LG, Glazkov AA, Britvin TA. Experience of using the Bethesda system in evaluating the results of fine needle biopsy of thyroid nodules. RMJ. 2018;1(1):23-7 (In Russ.)].
- Романчишен А.Ф. Хирургия щитовидной и паращитовидных желез. СПб.: Вести, 2009 [Romanchishen AF. Surgery of the thyroid and parathyroid glands. Saint Petersburg: Vesti, 2009 (In Russ.)].
- Haugen BR, Alexander EK, Bible KC, et al. 2015 American Thyroid Association management guidelines for adult patients with thyroid nodules and differentiated thyroid cancer: The American Thyroid Association Guidelines task force on thyroid nodules and differentiated thyroid cancer. Thyroid. 2016;26(1):1–133. doi: 10.1089/thy.2015.0020
- Jemal A, Bray F, Center MM, et al. Global cancer statistics. CA Cancer J Clin. 2011;61(2):69-90. doi: 10.3322/caac.20107
- Суздальцев И.В., Пыхтин Ю.Ю., Кубанов С.И. Диагностика узловых образований щитовидной железы на фоне аутоиммунного тиреоидита. Кубанский научный медицинский вестник. 2009;1(106):115-8 [Suzdal’tsev IV, Pykhtin IuIu, Kubanov SI. Nodal Diagnostics thyroid formations on the background of autoimmune thyroiditis. Kuban Scientific Medical Bulletin. 2009;1(106):115-8 (In Russ.)].
- Боберь Е.Е., Фролова И.Г., Чойнзонов Е.Л., и др. Возможности высокопольной магнитно-резонансной томографии в диагностике узловых образований щитовидной железы. Сибирский онкологический журнал. 2013;3(57):14-9 [Bober EE, Frolova IG, Choinzonov EL, et al. Possible high field magnetic resonance tomography in the diagnosis of nodular formations of thyroid gland. Sibirski oncologicheski journal. 2013;3(57):14-9 (In Russ.)].
- Дедов И.И., Мельниченко Г.А., Герасимов Г.Л., и др. Клинические рекомендации российской ассоциации эндокринологов по диагностике и лечению аутоиммунного тиреоидита у взрослых. Проблемы эндокринологии. 2003;49(6):51 [Dedov II, Melnichenko GA, Gerasimov GL, et al. Clinical recommendations of the Russian Association endocrinologists for the diagnosis and treatment of autoimmoon thyroiditis in adults. Problems of Endocrinology. 2003;49(6):5 (In Russ.)].
- Борсуков А.В. Комментарии и обсуждение Всемирных рекомендаций 2015 года по эластографии щитовидной железы. Эндокринная хирургия. 2017;11(2):61-9 [Borsukov AV. Comments and discussion on the thyroid gland elastography World Recommendations 2015. Endocrine Surgery. 2017;11(2):61-9 (In Russ.)]. doi: 10.14341/serg201726169
- Борсуков А.В. Быть или не быть TI-RADS: полемические заметки с Евразийского форума по раку щитовидной железы. Эндокринная хирургия. 2016;10(3):33-6 [Borsukov AV. TI-RADS: to be or not to be. Polemic notes from the Eurasian Forum on thyroid cancer. Endocrine Surgery. 2016;10(3):33-6 (In Russ.)]. doi: 10.14341/serg2016333_36
- Reading CC, Charboneau JW, Hay ID, Sebo TJ. Sonography of thyroid nodules: a “classic pattern” diagnostic approach. Ultrasound Q. 2005;21:157-65.
- Malterling RR, Andersson R, Falkmer S, et al. Differentiated thyroid cancer in a Swedish county-long-term results and qualityof life. Acta Oncol. 2010;49(4):454-9. doi: 10.3109/02841860903544600
- Gürsoy A, Erdoğan MF. Ultrasonographic Approach to Thyroid Nodules: State of Art. Thyroid Intl. 2012;3:3-14.
- Magri F, Chytiris S, Capelli V, et al. Shear wave elastography in the diagnosis of thyroid nodules: feasibility in the case of coexistent chronic autoimmune Hashimoto’s thyroiditis. Clin Endocrinol (Oxf). 2012;76(1):137-41. doi: 10.1111/j.1365-2265.2011.04170.x
- Катрич А.Н., Охотина А.В., Квасова А.А., Рябин Н.С. Оценка эффективности компрессионной эластографии в диагностике рака щитовидной железы. Инновационная медицина Кубани. 2017;1(5):17-22 [Katrich АN, Okhotina AV, Kvasova A.A, Riabin NS. Strain elastography efficiency for thyroid gland cancer diagnosis. Innovatsionnaia meditsina Kubani. 2017;1(5):17-22 (In Russ.)].
- Митьков В.В., Иванишина Т.В., Митькова М.Д. Эластография сдвиговой волной в диагностике доброкачественных образований щитовидной железы. Ультразвуковая и функциональная диагностика. 2015;1:10-21 [Mit’kov VV, Ivanishina TV, Mit’kova MD. Shear Wave Elastography in Multiparametric Ultrasound of Malignant Thyroid Nodules. Ul’trazvukovaia i funktsional’naia diagnostika. 2015;1:10-21 (In Russ.)].
- Паршин В.С., Тарасова Г.П., Павлинова Е.С. Эластография сдвиговой волны в дифференциальной диагностике доброкачественной и злокачественной природы узловых образований щитовидной железы. Радиация и риск. 2014;23(2):72-84 [Parshin VS, Tarasova GP, Pavlinova ES. Shear wave elastography in the differential diagnosis of benign and malignant thyroid nodules. Radiatsiia i risk. 2016;23(2):72-84 (In Russ.)].