Objective: This study aimed to assess the diagnostic value of contrast-enhanced ultrasound (CEUS) time-intensity curve (TIC) parameters in detecting non-ossified thyroid cartilage invasion in patients with laryngeal squamous cell carcinoma (SCC). Methods: A CEUS TIC analysis was performed on 32 cases from 27 patients with histologically confirmed laryngeal SCC. The diagnostic performance of time to peak (TTP), peak intensity (PI), wash-in slope (WIS), area under the curve (AUC), and their quantitative differences (triangle TTP, triangle PI, triangle WIS, and triangle AUC) to discriminate between the invaded and the non-invaded non-ossified thyroid cartilage was determined using ROC analysis. A logistic regression analysis was employed to identify significant predictors. Results: In an ROC analysis, of all TIC parameters analyzed separately, triangle TTP showed the greatest diagnostic performance (AUC: 0.85). A triangle TTP cut-off of <= 8.9 s differentiated between the invaded and the non-invaded non-ossified thyroid cartilage with a sensitivity of 100%, specificity of 76.9%, and accuracy of 81.3%. A combination of triangle TTP and PI increased the AUC to 0.93, specificity to 100%, and accuracy to 96.8%, but reduced the sensitivity to 83.3%. Meanwhile, the visual assessment of enhancement on CEUS to detect cartilage invasion had 83.3% sensitivity and 84.6% specificity. In a univariate logistic regression, only triangle TTP was a significant predictor of non-ossified thyroid cartilage invasion (OR: 0.80; 95% CI: 0.64-1.00). For every second increase in triangle TTP, the probability of thyroid cartilage invasion decreased by 20%. Conclusions: CEUS TIC parameters, particularly a combination of triangle TTP and PI, showed high diagnostic performance in the detection of non-ossified thyroid cartilage invasion in laryngeal SCC.
Time-Intensity Curve Analysis of Contrast-Enhanced Ultrasound for Non-Ossified Thyroid Cartilage Invasion in Laryngeal Squamous Cell Carcinoma
Farina D.;
2025-01-01
Abstract
Objective: This study aimed to assess the diagnostic value of contrast-enhanced ultrasound (CEUS) time-intensity curve (TIC) parameters in detecting non-ossified thyroid cartilage invasion in patients with laryngeal squamous cell carcinoma (SCC). Methods: A CEUS TIC analysis was performed on 32 cases from 27 patients with histologically confirmed laryngeal SCC. The diagnostic performance of time to peak (TTP), peak intensity (PI), wash-in slope (WIS), area under the curve (AUC), and their quantitative differences (triangle TTP, triangle PI, triangle WIS, and triangle AUC) to discriminate between the invaded and the non-invaded non-ossified thyroid cartilage was determined using ROC analysis. A logistic regression analysis was employed to identify significant predictors. Results: In an ROC analysis, of all TIC parameters analyzed separately, triangle TTP showed the greatest diagnostic performance (AUC: 0.85). A triangle TTP cut-off of <= 8.9 s differentiated between the invaded and the non-invaded non-ossified thyroid cartilage with a sensitivity of 100%, specificity of 76.9%, and accuracy of 81.3%. A combination of triangle TTP and PI increased the AUC to 0.93, specificity to 100%, and accuracy to 96.8%, but reduced the sensitivity to 83.3%. Meanwhile, the visual assessment of enhancement on CEUS to detect cartilage invasion had 83.3% sensitivity and 84.6% specificity. In a univariate logistic regression, only triangle TTP was a significant predictor of non-ossified thyroid cartilage invasion (OR: 0.80; 95% CI: 0.64-1.00). For every second increase in triangle TTP, the probability of thyroid cartilage invasion decreased by 20%. Conclusions: CEUS TIC parameters, particularly a combination of triangle TTP and PI, showed high diagnostic performance in the detection of non-ossified thyroid cartilage invasion in laryngeal SCC.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
