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CLC number: R445.3

On-line Access: 2018-03-05

Received: 2017-03-06

Revision Accepted: 2017-06-21

Crosschecked: 2018-02-10

Cited: 0

Clicked: 2947

Citations:  Bibtex RefMan EndNote GB/T7714

 ORCID:

Le-xing Zhang

https://orcid.org/0000-0002-2346-7979

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Journal of Zhejiang University SCIENCE B 2018 Vol.19 No.3 P.211-217

http://doi.org/10.1631/jzus.B1700119


Diagnostic value of computed tomography (CT) histogram analysis in thyroid benign solitary coarse calcification nodules


Author(s):  Le-xing Zhang, Jing-jing Xiang, Pei-ying Wei, Jin-wang Ding, Ding-cun Luo, Zhi-yi Peng, Zhi-jiang Han

Affiliation(s):  Department of Radiology, Hangzhou First Peoples Hospital, Hangzhou 310006, China

Corresponding email(s):   pengzhiyi2010@163.com, hanzhijiang97@126.com

Key Words:  Thyroid nodule, Thyroid cancer, Coarse calcification, Computed tomography histogram


Le-xing Zhang, Jing-jing Xiang, Pei-ying Wei, Jin-wang Ding, Ding-cun Luo, Zhi-yi Peng, Zhi-jiang Han. Diagnostic value of computed tomography (CT) histogram analysis in thyroid benign solitary coarse calcification nodules[J]. Journal of Zhejiang University Science B, 2018, 19(3): 211-217.

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author="Le-xing Zhang, Jing-jing Xiang, Pei-ying Wei, Jin-wang Ding, Ding-cun Luo, Zhi-yi Peng, Zhi-jiang Han",
journal="Journal of Zhejiang University Science B",
volume="19",
number="3",
pages="211-217",
year="2018",
publisher="Zhejiang University Press & Springer",
doi="10.1631/jzus.B1700119"
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%T Diagnostic value of computed tomography (CT) histogram analysis in thyroid benign solitary coarse calcification nodules
%A Le-xing Zhang
%A Jing-jing Xiang
%A Pei-ying Wei
%A Jin-wang Ding
%A Ding-cun Luo
%A Zhi-yi Peng
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A1 - Jin-wang Ding
A1 - Ding-cun Luo
A1 - Zhi-yi Peng
A1 - Zhi-jiang Han
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DOI - 10.1631/jzus.B1700119


Abstract: 
This study was to investigate the diagnostic value of the computed tomography (CT) histogram in thyroid benign solitary coarse calcification nodules (BSCNs). A total of 89 thyroid solitary coarse calcification nodules (coarse calcification ≥5 mm, no definite soft tissue around calcification) confirmed either by surgery or histopathological examination in 86 cases enrolled from January 2009 to December 2015 were evaluated. These included 56 BSCNs and 33 malignant solitary coarse calcification nodules (MSCNs). Overall, 27 cut-off values were calculated by N (4≤N≤30) times of 50 Hounsfield units (HU) in the range of 200 to 1500 HU, and each cut-off value and the differences in the corresponding area percentages in the CT histogram were recorded for BSCN and MSCN. The optimal cut-off value and the corresponding area percentage were established by receiver operating characteristic (ROC) curve analysis. In the 19 groups with an ROC area under curve (AUC) of more than 0.7, at a cut-off value of 800 HU and at an area percentage of no more than 93.8%, the ROC AUC reached the maximum of 0.79, and the accuracy, sensitivity, and specificity were 75.3%, 80.4%, and 66.7%, respectively. At a cut-off value of 1050 HU and at an area percentage of no more than 93.6%, the accuracy, sensitivity, and specificity were 71.9%, 60.7%, and 90.9%, respectively. At a cut-off of 1150 HU and area of no more than 98.4%, the accuracy, sensitivity, and specificity were 70.8%, 57.1%, and 93.9%, respectively. At a cut-off of 600 HU and area of no more than 12.1%, the accuracy, sensitivity, and specificity were 61.8%, 39.3%, and 100.0%, respectively. Compared with the cut-off value of 800 HU and an area percentage of no more than 93.8%, the sensitivity of cut-off values and minimum areas of 1050 HU and 93.6%, of 1150 HU and 98.4%, and of 600 HU and 12.1%, was gradually decreasing; however, their specificity was gradually increasing. This can provide an important basis for reducing the misdiagnosis and unnecessary surgical trauma.

计算机断层扫描(CT)直方图在甲状腺良性孤立性粗钙化结节诊断中的价值

目的:探讨CT直方图在甲状腺良性孤立性粗钙化结节(BSCN)诊断中的价值.
创新点:首次采用CT直方图来对甲状腺结节进行良恶性的鉴别诊断,并找到有较好临床诊断价值截点值.
方法:收集2009年1月至2015年12月期间,经手术及病理证实的甲状腺孤立粗钙化结节(粗钙化直径 ≥5 mm,周围无软组织)86例89枚,包括54例56枚BSCNs和32例33枚恶性孤立性粗钙化结节(MSCNs).在200~1500 HU的范围内,以50 HU的N(4≤N≤30)倍为截点,共计27个,记录CT直方图中BSCN和MSCN各截点及其所占面积百分比的差异,通过ROC曲线确定诊断BSCN的最佳截点及其面积百分比.
结论:在19组受试者工作特征曲线(ROC)面积超过0.7的数据中,当800 HU和面积百分比≤93.8%时,准确度最高,为75.3%,敏感度和特异度分别为80.4%和66.7%;当1050 HU和百分比≤93.6%时,准确度为71.9%,敏感度和特异度分别为60.7%和90.9%;当1150 HU和百分比≤98.4%时准确度为70.8%,敏感度和特异度分别为57.1%和93.9%;当600 HU和百分比≤12.1%时准确度为61.8%,敏感度和特异度分别为39.3%和100%.与截点800 HU和面积百分比≤93.8%比较发现,尽管1050 HU和百分比≤93.6%、1150 HU和百分比≤98.4%、600 HU和百分比≤12.1%对BSCN诊断的敏感度有所降低,但特异度显著升高,从而为BSCN患者减少了不必要的手术创伤.

关键词:甲状腺结节;甲状腺癌;粗钙化;CT直方图

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