Non-enhanced ultrasound is not a satisfactory modality for measuring necrotic ablated volume after radiofrequency ablati
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ULTRASOUND
Non-enhanced ultrasound is not a satisfactory modality for measuring necrotic ablated volume after radiofrequency ablation of benign thyroid nodules: a comparison with contrast-enhanced ultrasound Lin Yan 1,2
&
Yukun Luo 1
&
Jing Xiao 1 & Lin Lin 1
Received: 5 May 2020 / Revised: 2 September 2020 / Accepted: 8 October 2020 # European Society of Radiology 2020
Abstract Objective To investigate the intra- and inter-observer reliability and agreement between gray-scale and Doppler ultrasound (US) and contrast-enhanced ultrasound (CEUS) in measuring ablated volume (Va) after radiofrequency ablation (RFA) for benign thyroid nodules. Methods A total of 173 patients with 190 benign thyroid nodules who underwent RFA were included in this study. After RFA, the total volume of ablated nodule was divided into Va and the incompletely treated vital volume. Patients were followed up at 1, 3, 6, 12 months, and every 12 months thereafter. Two independent observers measured Va using US and CEUS during the same follow-up visit. The intra- and inter-observer reliability of the two measurement modalities was assessed using intraclass correlation coefficient (ICC) with 95% confidence interval. The Bland-Altman analysis was used to evaluate agreement, which was expressed as a mean difference with 95% limits of agreement (LOA). Results The mean follow-up time was 23.17 ± 12.70 months. Va measured by US was significantly larger than by CEUS (p < 0.001). The intra- and inter-observer reliability decreased over the follow-up period and became moderate in both subgroups at 12 months (all ICC < 0.75). The mean difference and LOA became larger and wider during the follow-up. The best agreement was found in nodules < 10 ml at 1 month with a mean difference of 1.166 and LOA between 0.413 and 3.294. Conclusions The intra- and inter-observer reliability and agreement of US and CEUS in measuring Va were unsatisfactory. CEUS should be considered when Va was needed for further evaluation or in the case of nodules with suspected regrowth. Key Points • Va measured by gray-scale and Doppler US was significantly larger than that by CEUS. • Va measured by gray-scale and Doppler US lacked intra- and inter-observer reliability and agreement with CEUS. • CEUS should be preceded to gray-scale and Doppler US for the measurement of Va. Keywords Radiofrequency ablation . Thyroid nodule . Ultrasonography . Reproducibility of results
* Yukun Luo [email protected] 1
Department of Ultrasound, First Medical Center, Chinese PLA General Hospital, No. 28 Fuxing Road, Haidian District, Beijing, China
2
Health Management Center, The Second Hospital of Dalian Medical University, No. 467 Zhongshan Road, Shahekou District, Dalian, China
Abbreviations CEUS Contrast-enhanced ultrasound CIs Confidence intervals LOA 95% limits of agreement ICC Intraclass correlation coefficient RFA Radiofrequency ablation US Gray-scale and Doppler ultrasound Vt Total volume Va Ablated volume Vv Vital volume VRR Volume reduction rate
Eur Radiol
Introduction Radiofrequency a
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