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© 2008 by the American Institute of Ultrasound in Medicine
J Ultrasound Med 27:1727-1733 • 0278-4297

Thyroid Volumetric Quantification

Comparative Evaluation Between Conventional and Volumetric Ultrasonography

Roberto Malago, MD, Mirko D’Onofrio, MD, Marco Ferdeghini, MD, William Mantovani, MD, Chiara Colato, MD, Paolo Brazzarola, MD, Massimiliano Motton, MD and Roberto Pozzi Mucelli, MD

Departments of Radiology (R.M., M.D., M.F., M.M., R.P.M.), Public Health (W.M.), Pathology (C.C.), and Surgery (P.B.), Policlinico G. B. Rossi, University of Verona, Verona, Italy

Address correspondence to Roberto Malago, MD, Department of Radiology, Policlinico G. B. Rossi, University of Verona, Piazzale L. A. Scuro 10, 37134 Verona, Italy. E-mail: rmalag{at}sirm.org

Objective. Thyroid volume quantification is an important parameter for radiotherapy dosing in cases of major thyroid diseases such as thyroiditis and carcinoma. In clinical practice, this calculation is performed by means of ultrasonography on the basis of an ellipsoid formula obtained from the 3 axes. The aim of our study was to compare the accuracy of volume calculation between B-mode ultrasonography and volumetric ultrasonography (VUS). Methods. Between April and May 2007, 27 consecutive patients selected for thyroidectomy were prospectively evaluated. One expert ultrasound operator calculated each thyroid volume with standard B-mode ultrasonography on the basis of the 3 axes of each lobe, and then the patients were analyzed with an offline workstation equipped with volumetric probes (VUS). On the offline workstation, 2 separate blinded operators (VUS1 and VUS2) calculated the thyroid volume with virtual organ computer-aided analysis. Data acquired were then compared with pathologic anatomy (PA). Results. The mean time for B-mode analysis was 6 minutes, whereas VUS analysis needed a mean time of 16.5 minutes. Interobserver variability between the median VUS1 and VUS2 measurements was 0.36 mL (interquartile range [IQR], –0.79 to 0.37 mL; P < .156). The median variability between B-mode ultrasonography and PA was –9.6 mL (IQR, –16.7 to 1.5 mL; P < .001), and that between VUS and PA was –2.87 mL (IQR, –11.97 to 9.51 mL; P = .019). The overall performance of B-mode ultrasonography in comparison with PA was –29.1% (IQR, –47.5% to –5.9%), and that of VUS in comparison with PA was –6.3% (IQR, –26.3 to 13.7%; P < .001). Conclusions. Volumetric ultrasonography is a valid tool that compares better with PA than does B-mode ultrasonography.

Key Words: radioiodine therapy • thyroid gland, ultrasonography • volumetric ultrasonography

Abbreviations: CT, computed tomography • IQR, interquartile range • PA, pathologic anatomy • 3D, 3-dimensional • 2D, 2-dimensional • VOCAL, virtual organ computer-aided analysis • VUS, volumetric ultrasonography

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Copyright © 2008 by the American Institute of Ultrasound in Medicine.