Stitching of sensor-navigated 3D ultrasound datasets for the determination of large thyroid volumes - a phantom study

Thyroid volume has to be measured in goiters prior to radioiodine treatment to calculate the needed amount of radioactivity. Modern clinical equipment for ultrasonography shows the trend to smaller probes, so that larger goiters do not fit any longer into the probe's field of view. This study evaluated the feasibility and accuracy of stitching procedures applied to thyroid volumetric analysis performed using three-dimensional ultrasound (3D-US).

Ad hoc thyroid phantoms of different shapes (regular, nodular, thickened isthmus) and volumes (ranging between 50 and 400 mL) were developed. In 15 such phantoms the left and right lobes were separately scanned, and the 3D-US datasets were then assembled (stitched) using predefined landmarks and dedicated software. Volumetric analysis was then assessed via a conventional ellipsoid model (em) and manual tracing (mt). The correlation of measured and reference volumes was determined using Pearson's correlation coefficients and Bland and Altman limits of agreement.

The results showed a high level of agreement (with correlation coefficients ranging from 0.974 to 0.999) for all shapes and volumes tested, including the largest volume of 400 mL. The mt method, although more time consuming, proved superior to the em.

Stitching-mediated thyroid volumetric analysis is accurate, and its clinical performance should be investigated in future studies.