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A Swin Transformer-Based Model for Thyroid Nodule Detection in Ultrasound Images
Published on: April 21, 2023
Distinguishing mummified thyroid nodules from malignant thyroid nodules
Xiao Qu Tan1, LinXue Qian2, YunHong Wang3
1Department of ultrasound, Beijing Friendship Hospital, NO.95 Yongan Road, Xicheng District, Beijing. txqtan0505@sina.com.
Insights
Ultrasonography can identify "mummified" thyroid nodules using specific signs like cystic wall shrinkage and concentric configuration. These ultrasonographic features aid in differentiating mummified nodules from malignant thyroid cancer, potentially avoiding unnecessary biopsies.
Area of Science:
- Radiology
- Endocrinology
- Oncology
Background:
- Thyroid nodules are common, with malignancy being a primary concern.
- Accurate differentiation between benign and malignant nodules is crucial for patient management.
- Distinguishing
- mummified
- thyroid nodules from malignant ones can be challenging with conventional imaging.
Purpose of the Study:
- To identify ultrasonographic (US) features that differentiate "mummified" thyroid nodules from malignant thyroid nodules.
- To improve the accuracy of imaging-based diagnosis for thyroid nodules.
- To reduce the need for unnecessary fine-needle aspiration cytology (FNAC) biopsies.
Main Methods:
- Retrospective review of US features in 193 confirmed "mummified" thyroid nodules and 109 malignant thyroid lesions.
- Analysis of US characteristics including content, echo, shape, margin, microcalcification, lymph nodes, and specific signs.
- Evaluation of nodule changes during follow-up imaging.
Main Results:
- The cystic wall shrinkage sign and concentric configuration or finger sign were highly specific for "mummified" thyroid nodules.
- These signs demonstrated high specificity (91.7% and 99.9%) in distinguishing "mummified" from malignant nodules.
- A continuous decrease in cyst size was observed in "mummified" nodules during follow-up.
Conclusions:
- "Mummified" thyroid nodules exhibit characteristic US features: cystic wall shrinkage sign and concentric configuration or finger sign.
- These US findings, along with size reduction over time, aid in differentiating "mummified" from malignant thyroid nodules.
- Ultrasonography can facilitate accurate imaging-based differential diagnosis, potentially reducing invasive procedures.
Aim:
To study the ultrasonographic (US) differences between "mummified" thyroid nodules and malignant thyroid nodules in order to achieve a more accurate imaging-based diagnosis and to avoid unnecessary biopsy.
Material And Methods:
We retrospectively reviewed the US features of mummified thyroid nodules, as confirmed by fine-needle aspiration cytology (FNAC), in 193 cases. The US features included content, echo, shape, margin, microcalcification, suspicious lymph nodes and some characteristic features, including the cystic wall shrinkage sign, the concentric configuration or finger sign, calcification and halo. All of these features were classified and compared with those of 109 malignant lesions. The changes of these mummified nodules during the follow-up period were also examined.
Results:
The cystic wall shrinkage sign and the concentric configuration or finger sign were highly specific indicators of mummified thyroid nodules and could be used to distinguish mummified nodules from thyroid cancer with a specificity of 91.7% and 99.9%, respectively. A continuous decrease in the cyst size was observed during follow-up.
Conclusions:
Mummified thyroid nodules are characterized by the cystic wall shrinkage sign and the concentric configuration or finger sign on US and a continuous decrease in size during follow-up. These features may be useful for the differential imaging-based diagnosis of mummified versus malignant thyroid nodules.
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