Power Doppler US patterns of vascularity and spectral Doppler US parameters in predicting malignancy in thyroid...

The purpose of this study was to determine whether spectral Doppler ultrasound (US) parameters, including resistive index (RI) and maximal systolic velocity (MSV), or vascular pattern can be used to distinguish malignant from benign thyroid nodules.

We prospectively examined 169 thyroid nodules in 134 patients undergoing sonographically guided fine-needle aspiration biopsy (FNAB). Vascularity as determined by power Doppler US imaging was defined as absent, perinodular alone, or intranodular. For each nodule, the RI and MSV values were recorded as the average of the recordings obtained. Results of the FNAB and surgical pathological examination, if available, were used as a proof of final diagnosis to categorize all nodules as benign or malignant.

Seven nodules were excluded from study because of non-diagnostic FNAB results due to hypocellular or insufficient cytological material. Of the remaining nodules, nine were malignant (all confirmed at surgery) and 153 were benign. Of the 145 nodules with intranodular vascularity, nine (6.2%) were malignant and the remaining 136 (93.8%) were benign. The malignant nodules had a mean RI of 0.60 on intranodular and 0.58 on perinodular arteries. These values were not significantly higher than those associated with benign nodules (RI=0.57 and RI=0.56, respectively). Malignant nodules had a mean MSV of 20.4cm/s on intranodular and 35.3cm/s on perinodular arteries that were also not significantly different from those associated with benign nodules (p>0.05).

The results of this study indicate that Doppler US characteristics including vascular pattern, RI and MSV are not useful parameters for distinguishing malignant from benign thyroid nodules. Therefore, Doppler US characteristics including vascular pattern, RI and MSV values of thyroid nodules can not be used as a diagnostic method to determine which nodules should undergo FNAB.