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Three-Dimensional Ultrasonography for Volume Measurement of Thyroid Nodules in Children

Laboratory of Thyroidology, Clinical Research Institute for Radiation Medicine and Endocrinology, Minsk, Belarus (A.L., V.D.); Department of Nuclear Medicine and Diagnostic Imaging, Kyoto University Graduate School of Medicine, Kyoto, Japan (A.L.); and Clinic and Policlinic for Nuclear Medicine, University of Würzburg, Würzburg, Germany (S.S., C.R.).

Address correspondence and reprint requests to Andrej Lyshchik, MD, Department of Nuclear Medicine and Diagnostic Imaging, Kyoto University Graduate School of Medicine, 54 Kawahara-cho, Shogoin, Sakyo-ku 606-8507, Kyoto, Japan. E-mail: lyshchik{at}kuhp.kyoto-u.ac.jp.

Objective. The aim of this study was to compare the accuracy of thyroid nodule volume measurements performed by 2- and 3-dimensional ultrasonography and to evaluate the dependence of volume measurement results on nodule size and echographic characteristics. Methods. Results of multiple 2- and 3-dimensional ultrasonographic volume measurements of thyroid nodules in 102 children with different variants of thyroid nodular disease were reviewed retrospectively. The standardized difference, within-observer variability, and repeatability were estimated for both 2- and 3-dimensional ultrasonography. The mean age of the patients ± SD in the examined group was 14.9 ± 2.8 years; the mean volume of thyroid nodules was 0.78 ± 0.13 mL. Results. The SD of the normalized difference for 3-dimensional ultrasonography (2.8%) showed the clear superiority of its accuracy over 2-dimensional ultrasonography (15.9%; F test, P < .01). Intraobserver variability and repeatability for both examined methods had significant dependence on the nodule outline. For 2-dimensional ultrasonography, the intraobserver variability increased from 14.0% in nodules with a regular outline to 24.5% in those with an irregular outline (P < .001), and for 3-dimensional ultrasonography, it increased from 5.1% to 9.3% (P < .001). Intraobserver repeatability dropped from 85.4% in regular nodules to 74.6% in irregular nodules (P < .001) for 2-dimensional ultrasonography and from 94.7% to 90.4% (P < .001) for 3-dimensional ultrasonography. Conclusions. Volume measurements by 3-dimensional ultrasonography are more accurate, showing lower intraobserver variability and higher repeatability, than those made by 2-dimensional ultrasonography with less dependence on nodule size and echographic characteristics.

Key Words: 3-dimensional ultrasonography • thyroid nodules • volume measurements

Abbreviations: 3D, three-dimensional • 3D US, 3-dimensional ultrasonography • 2D US, 2-dimensional ultrasonography

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