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Master Thesis

Impact diagnostique de la normalisation de l'échogénicité des nodules thyroïdiens

Abstract : Thyroid nodules are usually explored non-invasively by ultrasonography followed by an invasive cytopunction in case of suspected cancer. Echogenicity of the thyroid nodule is a key parameter to differentiate benign and malignant nodules but its visual determination lacks reproducibility. The objective of this r.tudy was to define and evaluate a standardized measurement cf thvroid natures' echogenicity. In this monocentric study, ultrasound data .(2D recorded images, echogenicity and EU-TIRADS (European Thyroid Imaging Reporting And Data System) score determined visually by an experienced physician) and cytological results of cytopunctions performed between June 2016 and January 2019 were retrieved retrospectively. A manual segmentation on the 20 recorded images of the nodules, the healthy thyroid and the cervical muscles was performed to measure the nodules' echogenicity normalized by the healthy thyroid (Nt) and the muscles (Nm). Spearman's correlations were used to compare the parameters and a comparative analysis of diagnostic performance by ROC (Receiving Operator Characteristic) curves by using cytological Bethesda results as reference. 201 patients (224 nodules) with thyroid cytopunctions were included and analyzed. Concerning the Spearman's correlations, the measured parameters were moderately correlated to the EU-TIRADS (maximal p=-0,60, p<0.05 for Nt). On ROC curve analysis, echogenicity of the nodules normalized by the healthy thyroid showed an area under the curve comparable to the EU-TIRADS score, equal to 0.64 and 0.62 respectively to differentiate benign (Bestheda II) versus others (Bethesda III, iV, V and VI) cytologies. Results were equal to 0.76 and 0.79 respectively to differentiate benign (Bestheda II) versus highly suspicious (Bethesda V and VI) cytologies with an high accuracy in this case (0.88 and 0.85). Nodular edhoperficity quantified and normalized by beaIthy. thyroid echogenicity provides diagnostic -performance comparable 'to the -EU-T1RADS score While offering the possibility of being determined simply and retrospectively on 2D recorded images. It could provide an objective additional support to the current EU-TIRADS classification, in particular for non-specialist teams.
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Master Thesis
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https://dumas.ccsd.cnrs.fr/dumas-02862453
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Submitted on : Tuesday, June 9, 2020 - 3:17:39 PM
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  • HAL Id : dumas-02862453, version 1

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Benjamin Viard. Impact diagnostique de la normalisation de l'échogénicité des nodules thyroïdiens. Médecine humaine et pathologie. 2019. ⟨dumas-02862453⟩

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