EndocrinologiaOggi

Rome, Italy

EndocrinologiaOggi

Rome, Italy
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Andrioli M.,EndocrinologiaOggi | Andrioli M.,Instituto Auxologico Italiano | Persani L.,Instituto Auxologico Italiano | Persani L.,University of Milan
Endocrine | Year: 2014

Thyroid nodules are very common with malignancies accounting for about 5 %. Fine-needle biopsy is the most accurate test for thyroid cancer diagnosis. Elastography, a new technology directly evaluating the elastic property of the tissue, has been recently added to the diagnostic armamentarium of the endocrinologists as noninvasive predictor of thyroid malignancy. In this paper, we critically reviewed characteristics and applications of elastographic methods in thyroid gland. Elastographic techniques can be classified on the basis of the following: source-of-tissue compression (free-hand, carotid vibration, ultrasound pulses), processing time (real-time, off-line), stiffness expression (qualitative, semi-quantitative, or quantitative). Acoustic radiation force impulse and aixplorer shear wave are the newest and most promising quantitative elastographic methods. Primary application of elastography is the detection of nodular lesions suspicious for malignancy. Published data show a high sensitivity and negative predictive value of the technique. Insufficient data are available on the possible application of elastography in the differential diagnosis of indeterminate lesions and in thyroiditis. Elastography represents a noninvasive tool able to increase the performance of ultrasound in the selection of thyroid nodules at higher risk of malignancy. Some technical improvements and definition of more robust quantitative diagnostic criteria are required for assigning a definite role in the management of thyroid nodules and thyroiditis to elastography. © 2014 Springer Science+Business Media.


Andrioli M.,EndocrinologiaOggi | Andrioli M.,Instituto Auxologico Italiano | Persani L.,Instituto Auxologico Italiano | Persani L.,University of Milan
Endocrine | Year: 2014

Synchronous metastasis of renal cell carcinoma (RCC) are extremely uncommon with only few sporadic cases published in the literature and data on their elastographic appearance are lacking. Here we described a case of woman with multinodular goiter bearing a RCC metastasis, in which exhaustive ultrasonographic and qualitative elastographic evaluation were performed. The metastatic lesion presented some suspicious ultrasonographic features but was mainly "soft" at qualitative elastographic evaluation, suggesting that RCC metastasis may represent a possible pitfall for the qualitative elastographic evaluation of thyroid nodules. © 2013 Springer Science+Business Media.


Andrioli M.,EndocrinologiaOggi | Andrioli M.,Endocrinology Unit | Valcavi R.,Endocrinology Unit
Endocrine | Year: 2014

The aim of percutaneous thermal ablation with laser (LA) or radiofrequency (RFA) is to reduce the volume of benign thyroid nodules. Little is known about ultrasonographic and elastographic appearances of thyroid lesions after treatment. For the first time, we report in detail the main ultrasonographic and elastographic characteristics of thermally ablated nodules and their underlying similarities and differences. Both thermal treatments usually produce a marked hypoechoic area of coagulative necrosis. LA-treated lesions usually become highly heterogeneous due to the presence of cavitations and charring; they then evolve into hyperechoic scars. In RFA-treated nodules, instead, the necrotic area is more homogeneous but presents more irregular margins compared to those observed in LA-treated lesions. Regardless of the thermal method used, vascularity is typically reduced in all treated nodules and stiffness, evaluated with qualitative elastography, increases. In conclusion, ultrasonographic and elastographic appearances of the thermally ablated thyroid lesions differ slightly according to the adopted procedure. Furthermore, they are peculiar, changeable over time, and potentially misleading. © 2014, Springer Science+Business Media New York.


Andrioli M.,EndocrinologiaOggi | Andrioli M.,Endocrinology Unit | Valcavi R.,Endocrinology Unit
Endocrine | Year: 2015

The aim of percutaneous thermal ablation is to reduce the volume of benign thyroid nodules. B-flow imaging, a non-Doppler technology for blood flow imaging, provides a real-time visualization of vascularity, and gives accurate information on the vessel lumen in high spatial and temporal resolution. Little is known about the possible application of this new technique on thyroid nodules after thermal treatments. Color power Doppler and contrast-enhanced ultrasound are the methods currently used in this context, but they present some limitations. Conversely, during the thermal procedures, B-flow imaging—suppressing unwanted signals (e.g., noise and tissue) and boosting weak signals (e.g., blood echoes)—permits an accurate spatial analysis of the intranodular flow. B-flow imaging may clearly show a complete ablation during the treatment. Moreover, it can also be useful during the follow-up in highlighting the possible intranodular flow regrowth. In conclusion, B-flow imaging—overcoming the limitations of color power Doppler and contrast-enhanced ultrasound—is useful to evaluate, in real time, the necrotic area of thyroid nodules during and after thermal ablative procedures. © 2014, Springer Science+Business Media New York.


Trimboli P.,Section of Endocrinology and Diabetology | Bini F.,University of Rome La Sapienza | Andrioli M.,EndocrinologiaOggi | Giovanella L.,Oncology Institute of Southern Switzerland | And 7 more authors.
Endocrine | Year: 2015

Since US is not easily reproducible, the digital image analysis (IA) has been proposed so that the image evaluation is not subjective. In fact, IA meets the criteria of objectivity, accurateness, and reproducibility by a matrix of pixels whose value is displayed in a gray level. This study aims at evaluating via IA the tissue surrounding a thyroid nodule (backyard tissue, BT) from goitres with benign (b-BT) and malignant (m-BT) lesions. Sixty-nine US images of thyroid nodules surrounded by adequate thyroid tissue was classified as normoechoic and homogeneous were enrolled as study group. Forty-three US images from normal thyroid (NT) glands were included as controls. Digital images of 800 × 652 pixels were acquired at a resolution of eight bits with a 256 gray levels depth. By one-way ANOVA, the 43 NT glands were not statistically different (P = 0.91). Mean gray level of normal glands was significantly higher than b-BT (P = 0.026), and m-BT (P = 0.0001), while no difference was found between b-BT and m-BT (P = 0.321). NT tissue boundary external to the nodule was found at 6.0 ± 0.5 mm in cancers and 4.0 ± 0.5 mm in benignancies (P = 0.001). These data should indicate that the tissue surrounding a thyroid nodule may be damaged even when assessed as normal by US. This is of interest to investigate the extranodular effects of thyroid tumors. © 2014, Springer Science+Business Media New York.


PubMed | EndocrinologiaOggi
Type: Case Reports | Journal: Endocrine | Year: 2014

Synchronous metastasis of renal cell carcinoma (RCC) are extremely uncommon with only few sporadic cases published in the literature and data on their elastographic appearance are lacking. Here we described a case of woman with multinodular goiter bearing a RCC metastasis, in which exhaustive ultrasonographic and qualitative elastographic evaluation were performed. The metastatic lesion presented some suspicious ultrasonographic features but was mainly soft at qualitative elastographic evaluation, suggesting that RCC metastasis may represent a possible pitfall for the qualitative elastographic evaluation of thyroid nodules.


PubMed | EndocrinologiaOggi
Type: Journal Article | Journal: Endocrine | Year: 2014

Thyroid nodules are very common with malignancies accounting for about 5 %. Fine-needle biopsy is the most accurate test for thyroid cancer diagnosis. Elastography, a new technology directly evaluating the elastic property of the tissue, has been recently added to the diagnostic armamentarium of the endocrinologists as noninvasive predictor of thyroid malignancy. In this paper, we critically reviewed characteristics and applications of elastographic methods in thyroid gland. Elastographic techniques can be classified on the basis of the following: source-of-tissue compression (free-hand, carotid vibration, ultrasound pulses), processing time (real-time, off-line), stiffness expression (qualitative, semi-quantitative, or quantitative). Acoustic radiation force impulse and aixplorer shear wave are the newest and most promising quantitative elastographic methods. Primary application of elastography is the detection of nodular lesions suspicious for malignancy. Published data show a high sensitivity and negative predictive value of the technique. Insufficient data are available on the possible application of elastography in the differential diagnosis of indeterminate lesions and in thyroiditis. Elastography represents a noninvasive tool able to increase the performance of ultrasound in the selection of thyroid nodules at higher risk of malignancy. Some technical improvements and definition of more robust quantitative diagnostic criteria are required for assigning a definite role in the management of thyroid nodules and thyroiditis to elastography.

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