DOI QR코드

DOI QR Code

Inter-Observer Variation in Ultrasound Measurement of the Volume and Diameter of Thyroid Nodules

  • Choi, Young Jun (Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Baek, Jung Hwan (Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Hong, Min Ji (Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Lee, Jeong Hyun (Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine)
  • Received : 2014.04.28
  • Accepted : 2015.01.14
  • Published : 2015.06.01

Abstract

Objective: Thyroid nodule measurement using ultrasonography (US) is widely performed in various clinical scenarios. The purpose of this study was to evaluate inter-observer variation in US measurement of the volume and maximum diameter of thyroid nodules. Materials and Methods: This retrospective study included 73 consecutive patients with 85 well-defined thyroid nodules greater than 1 cm in their maximum diameter. US examinations were independently performed by using standardized measurement methods, conducted by two clinically experienced thyroid radiologists. The maximum nodule diameter and nodule volume, calculated from nodule diameters using the ellipsoid formula, were obtained by each reader. Inter-observer variations in volume and maximum diameter were determined using 95% Bland-Altman limits of agreement. The degree of inter-observer variations in volumes and the maximum diameters were compared using the Student's t test, between nodules < 2 cm in maximum diameter and those with ${\geq}2cm$. Results: The mean inter-observer difference in measuring the nodule volume was -1.6%, in terms of percentage of the nodule volume, and the 95% limit of agreement was ${\pm}13.1%$. For maximum nodule diameter, the mean inter-observer difference was -0.6%, in terms of percentage of the nodule diameter, and the 95% limit of agreement was ${\pm}7.3%$. Inter-observer variation in volume was greater in nodules of < 2 cm in maximum diameter, compared to the larger nodules (p = 0.035). However, no statistically significant difference was noted between the two groups regarding maximum nodule diameters (p = 0.511). Conclusion: Any differences smaller than 13.1% and 7.3% in volume and maximum diameter, respectively, measured by using US for well-defined thyroid nodules of > 1 cm should not be considered as a real change in size.

Keywords

References

  1. American Thyroid Association (ATA) Guidelines Taskforce on Thyroid Nodules and Differentiated Thyroid Cancer, Cooper DS, Doherty GM, Haugen BR, Kloos RT, Lee SL, et al. Revised American Thyroid Association management guidelines for patients with thyroid nodules and differentiated thyroid cancer. Thyroid 2009;19:1167-1214 https://doi.org/10.1089/thy.2009.0110
  2. Gharib H, Papini E, Paschke R, Duick DS, Valcavi R, Hegedus L, et al. American Association of Clinical Endocrinologists, Associazione Medici Endocrinologi, and EuropeanThyroid Association Medical Guidelines for Clinical Practice for the Diagnosis and Management of Thyroid Nodules. Endocr Pract 2010;16 Suppl 1:1-43
  3. Moon WJ, Baek JH, Jung SL, Kim DW, Kim EK, Kim JY, et al. Ultrasonography and the ultrasound-based management of thyroid nodules: consensus statement and recommendations. Korean J Radiol 2011;12:1-14 https://doi.org/10.3348/kjr.2011.12.1.1
  4. Baek JH, Kim YS, Lee D, Huh JY, Lee JH. Benign predominantly solid thyroid nodules: prospective study of efficacy of sonographically guided radiofrequency ablation versus control condition. AJR Am J Roentgenol 2010;194:1137-1142 https://doi.org/10.2214/AJR.09.3372
  5. Baek JH, Moon WJ, Kim YS, Lee JH, Lee D. Radiofrequency ablation for the treatment of autonomously functioning thyroid nodules. World J Surg 2009;33:1971-1977 https://doi.org/10.1007/s00268-009-0130-3
  6. Jeong WK, Baek JH, Rhim H, Kim YS, Kwak MS, Jeong HJ, et al. Radiofrequency ablation of benign thyroid nodules: safety and imaging follow-up in 236 patients. Eur Radiol 2008;18:1244-1250 https://doi.org/10.1007/s00330-008-0880-6
  7. Sung JY, Baek JH, Kim KS, Lee D, Yoo H, Kim JK, et al. Single-session treatment of benign cystic thyroid nodules with ethanol versus radiofrequency ablation: a prospective randomized study. Radiology 2013;269:293-300 https://doi.org/10.1148/radiol.13122134
  8. Levine RA. Current guidelines for the management of thyroid nodules. Endocr Pract 2012;18:596-599 https://doi.org/10.4158/EP12071.CO
  9. Hegedus L, Karstrup S, Rasmussen N. Evidence of cyclic alterations of thyroid size during the menstrual cycle in healthy women. Am J Obstet Gynecol 1986;155:142-145 https://doi.org/10.1016/0002-9378(86)90098-0
  10. Bennedbaek FN, Nielsen LK, Hegedus L. Effect of percutaneous ethanol injection therapy versus suppressive doses of L-thyroxine on benign solitary solid cold thyroid nodules: a randomized trial. J Clin Endocrinol Metab 1998;83:830-835
  11. Dossing H, Bennedbaek FN, Hegedus L. Effect of ultrasound-guided interstitial laser photocoagulation on benign solitary solid cold thyroid nodules - a randomised study. Eur J Endocrinol 2005;152:341-345 https://doi.org/10.1530/eje.1.01865
  12. Brauer VF, Eder P, Miehle K, Wiesner TD, Hasenclever H, Paschke R. Interobserver variation for ultrasound determination of thyroid nodule volumes. Thyroid 2005;15:1169-1175 https://doi.org/10.1089/thy.2005.15.1169
  13. Moon WJ, Jung SL, Lee JH, Na DG, Baek JH, Lee YH, et al. Benign and malignant thyroid nodules: US differentiation--multicenter retrospective study. Radiology 2008;247:762-770 https://doi.org/10.1148/radiol.2473070944
  14. Frates MC, Benson CB, Charboneau JW, Cibas ES, Clark OH, Coleman BG, et al. Management of thyroid nodules detected at US: Society of Radiologists in Ultrasound consensus conference statement. Radiology 2005;237:794-800 https://doi.org/10.1148/radiol.2373050220

Cited by

  1. A Multicenter Prospective Validation Study for the Korean Thyroid Imaging Reporting and Data System in Patients with Thyroid Nodules vol.17, pp.5, 2015, https://doi.org/10.3348/kjr.2016.17.5.811
  2. ACR Thyroid Imaging, Reporting and Data System (TI-RADS): White Paper of the ACR TI-RADS Committee vol.14, pp.5, 2015, https://doi.org/10.1016/j.jacr.2017.01.046
  3. Factors related to recurrence of the benign non-functioning thyroid nodules after percutaneous microwave ablation vol.33, pp.4, 2015, https://doi.org/10.1080/02656736.2016.1274058
  4. Serial Neck Ultrasonographic Evaluation of Changes in Papillary Thyroid Carcinoma During Pregnancy vol.27, pp.6, 2017, https://doi.org/10.1089/thy.2016.0618
  5. Cancer Measurement at Ultrasound : State of the Art vol.33, pp.2, 2017, https://doi.org/10.1097/ruq.0000000000000266
  6. Active Surveillance for Patients With Papillary Thyroid Microcarcinoma: A Single Center’s Experience in Korea vol.102, pp.6, 2017, https://doi.org/10.1210/jc.2016-4026
  7. Selection and Reporting of Statistical Methods to Assess Reliability of a Diagnostic Test: Conformity to Recommended Methods in a Peer-Reviewed Journal vol.18, pp.6, 2017, https://doi.org/10.3348/kjr.2017.18.6.888
  8. Evaluation der Intra- und Inter observerübereinstimmung von99mTc-MIBI-Szintigraphien bei hypofunktionellen Knoten vol.56, pp.4, 2015, https://doi.org/10.3413/nukmed-0869-16-12
  9. Factors related to the efficacy of radiofrequency ablation for benign thyroid nodules vol.36, pp.4, 2017, https://doi.org/10.14366/usg.17034
  10. Interobserver reproducibility of maximal axial diameter and tumour volume measurements from CT of patients with head and neck squamous cell carcinoma vol.72, pp.11, 2017, https://doi.org/10.1016/j.crad.2017.06.006
  11. Intraobserver and Interobserver Variability in Ultrasound Measurements of Thyroid Nodules : Variability in Ultrasound Measurements of Thyroid Nodules vol.37, pp.1, 2015, https://doi.org/10.1002/jum.14316
  12. Initial Ablation Ratio: Quantitative Value Predicting the Therapeutic Success of Thyroid Radiofrequency Ablation vol.28, pp.11, 2015, https://doi.org/10.1089/thy.2018.0180
  13. Initial Ablation Ratio: Quantitative Value Predicting the Therapeutic Success of Thyroid Radiofrequency Ablation vol.28, pp.11, 2015, https://doi.org/10.1089/thy.2018.0180
  14. A Single-Center Retrospective Validation Study of the American College of Radiology Thyroid Imaging Reporting and Data System vol.34, pp.2, 2018, https://doi.org/10.1097/ruq.0000000000000350
  15. Interobserver Variability of Sonographic Features Used in the American College of Radiology Thyroid Imaging Reporting and Data System vol.211, pp.1, 2015, https://doi.org/10.2214/ajr.17.19192
  16. A Comparison of Ultrasound-Guided Fine Needle Aspiration versus Core Needle Biopsy for Thyroid Nodules: Pain, Tolerability, and Complications vol.33, pp.1, 2015, https://doi.org/10.3803/enm.2018.33.1.114
  17. Tumour growth rate of follicular thyroid carcinoma is not different from that of follicular adenoma vol.88, pp.6, 2015, https://doi.org/10.1111/cen.13591
  18. Can Thyroid Ultrasonography Predict Substernal Extension or Tracheal Compression in Goiters? vol.69, pp.4, 2018, https://doi.org/10.1016/j.carj.2018.07.007
  19. Sonographic Volumetric Assessment Is a More Accurate Measure Than Maximum Diameter Alone in Papillary Thyroid Cancer vol.2, pp.11, 2015, https://doi.org/10.1210/js.2018-00233
  20. Active Surveillance of Low-Risk Papillary Thyroid Microcarcinoma: A Multi-Center Cohort Study in Korea vol.28, pp.12, 2015, https://doi.org/10.1089/thy.2018.0263
  21. Thyroid Ultrasound Reports: Deficiencies and Recommendations vol.28, pp.3, 2019, https://doi.org/10.1159/000497789
  22. Tumor Growth Rate Does Not Predict Malignancy in Surgically Resected Thyroid Nodules Classified as Bethesda Category III with Architectural Atypia vol.29, pp.2, 2019, https://doi.org/10.1089/thy.2018.0366
  23. Ethanol ablation as a treatment strategy for benign cystic thyroid nodules: a comparison of the ethanol retention and aspiration techniques vol.38, pp.2, 2015, https://doi.org/10.14366/usg.18033
  24. Tumor Volume Doubling Time in Active Surveillance of Papillary Thyroid Carcinoma vol.29, pp.5, 2019, https://doi.org/10.1089/thy.2018.0609
  25. THYROID NODULE GROWTH AS A PREDICTOR OF MALIGNANCY vol.25, pp.10, 2015, https://doi.org/10.4158/ep-2019-0049
  26. Determining Whether Tumor Volume Doubling Time and Growth Rate Can Predict Malignancy After Delayed Diagnostic Surgery of Follicular Neoplasm vol.29, pp.10, 2019, https://doi.org/10.1089/thy.2019.0017
  27. Inter-observer reliability in ultrasound measurement of benign thyroid nodules in the follow-up of radiofrequency ablation: a retrospective study vol.37, pp.1, 2015, https://doi.org/10.1080/02656736.2020.1849826
  28. V Flow technology in measurement of wall shear stress of common carotid arteries in healthy adults: Feasibility and normal values vol.74, pp.4, 2015, https://doi.org/10.3233/ch-190719
  29. Roles of contrast-enhanced ultrasonography in identifying volume change of benign thyroid nodule and optical time of secondary radiofrequency ablation vol.20, pp.1, 2015, https://doi.org/10.1186/s12880-020-00476-1
  30. Malignancy Analyses of Thyroid Nodules in Patients Subjected to Surgery with Cytological- and Ultrasound-Based Risk Stratification Systems vol.1, pp.2, 2015, https://doi.org/10.3390/endocrines1020010
  31. Response to letter to the editor from Dr. Bernardi regarding suitability of residual vital ratio for prediction of local regrowth following radiofrequency ablation for benign thyroid nodules vol.38, pp.1, 2015, https://doi.org/10.1080/02656736.2021.1883128
  32. Interobserver Reproducibility in Sonographic Measurement of Diameter and Volume of Papillary Thyroid Microcarcinoma vol.31, pp.3, 2015, https://doi.org/10.1089/thy.2020.0317
  33. Risk Factors for Tumor Size Increase During Active Surveillance of Papillary Thyroid Cancer: Meta-Analysis and Systematic Review vol.64, pp.12, 2021, https://doi.org/10.3342/kjorl-hns.2021.00990
  34. Contrast-enhanced ultrasound is a reliable and reproducible assessment of necrotic ablated volume after radiofrequency ablation for benign thyroid nodules: a retrospective study vol.39, pp.1, 2015, https://doi.org/10.1080/02656736.2021.1991009