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Updated: Dec 18, 2025
Author Spotlight: Integrating Ultrasound Imaging with Biochemical Markers for Thyroid Disease Diagnosis
Published on: February 9, 2024
Evaluation of Underlying Lymphocytic Thyroiditis With Histogram Analysis Using Grayscale Ultrasound Images
Ga Ram Kim1, Eun-Kyung Kim1, Soo Jin Kim1
1Department of Radiology, Severance Hospital, Research Institute of Radiological Science, Yonsei University College of Medicine, Seoul, Korea (G.R.K., E.-K.K., J.H.Y., H.J.M., J.Y.K.); Department of Radiology, Chung-Ang University Hospital, Chung-Ang University College of Medicine, Seoul, Korea (S.J.K.); Department of Radiology, Ajou University School of Medicine, Suwon, Korea (E.J.H.); Yonsei University College of Medicine, Seoul, Korea (J.Y.); and Department of Research Affairs, Biostatistics Collaboration Unit, Yonsei University College of Medicine, Seoul, Korea (H.S.L., J.H.H.).
Objectives:
The purpose of this study was to evaluate diagnostic performance of histogram analysis using grayscale ultrasound (US) images in the diagnosis of lymphocytic thyroiditis.
Methods:
Three radiologists reviewed a total of 505 US images and classified the images according to the presence/existence of lymphocytic thyroiditis. After 2 months, each reviewer repeated the process with the same 505 images in a randomly mixed order. The intraobserver and interobserver variability was analyzed with a generalized κ value. Four histogram parameters (mean value, standard deviation, skewness, and kurtosis) were obtained, and an index was calculated from principal component analysis. Diagnostic performances were compared.
Results:
Of 505 patients, 125 (24.8%) had lymphocytic thyroiditis, and 380 (75.2%) had normal thyroid parenchyma on pathologic analysis. The κ value for intraobserver variance ranged from -0.002 to 0.781, and the overall κ values for interobserver variance were 0.570 and 0.214 in the first and second tests, respectively. The sensitivity, specificity, accuracy, positive predictive value, and negative predictive value for the 3 reviewers versus the principal component analysis index were 28.0% to 83.2%, 43.7% to 82.6%, 53.5% to 79.0%, 24.6% to 56.2%, and 75.2% to 88.9% versus 58.4%, 72.4%, 68.9%, 41.0%, and 84.1%.
Conclusions:
Histogram analysis of grayscale US images provided confirmable and quantitative information about lymphocytic thyroiditis and was comparable with performers' assessments in diagnostic performance.
