Abstract
This study aimed to assess the diagnostic performance of computed tomography (CT) for differentiating diffuse thyroid disease (DTD) from normal thyroid parenchyma (NTP) using multicenter data. Between January 2016 and June 2016, 229 patients underwent preoperative neck CT and subsequent thyroid surgery at five participating institutions. The neck CT images of each patient were retrospectively reviewed and classified into the following four categories: no DTD, indeterminate, suspicious for DTD, and DTD. The results of the CT image evaluations were compared with the histopathological results to determine the diagnostic accuracy of CT at each institution. According to the histopathological results, there were NTP (n = 151), Hashimoto thyroiditis (n = 24), non-Hashimoto lymphocytic thyroiditis (n = 47), and diffuse hyperplasia (n = 7). The CT categories of the 229 patients were “no DTD” in 89 patients, “indeterminate” in 40 patients, “suspicious for DTD” in 42 patients, and “DTD” in 58 patients. The presence of two or more CT features of DTD, which was classified as “suspicious for DTD” by all radiologists, had the largest area under the receiver-operating characteristic curve (Az = 0.820; 95% confidence interval: 0.764, 0.868), with sensitivity of 85.9% and specificity of 78.2%. However, no statistical significance between readers’ experience and their diagnostic accuracy was found. In conclusion, evaluations of CT images are helpful for differentiating DTD from NTP.
Highlights
Diffuse thyroid disease (DTD), a major cause of thyroid dysfunction, is classified into autoimmune and non-autoimmune diseases
This study follows the principles expressed in the Declaration of Helsinki, and this retrospective study examined patient data collected from five institutions that served as tertiary referral centers
The degree and pattern of parenchymal attenuation, glandular size, degree and pattern of parenchymal enhancement, thyroid margin, and computed tomography (CT) category were significantly different between patients with normal thyroid parenchyma (NTP) and those with DTD
Summary
Diffuse thyroid disease (DTD), a major cause of thyroid dysfunction, is classified into autoimmune and non-autoimmune diseases. CT diagnosis for DTD typically associated with hypothyroidism [1]. Previous studies have suggested an association between DTD and thyroid malignancy, the clinical significance of this relationship is still under debate [2,3,4]. Cases of symptomatic DTD are diagnosed by clinical and serological examinations, such as thyroid autoantibody or thyroid function tests; reliable diagnostic tools for detecting asymptomatic or subclinical DTD have not been established [5,6,7,8]
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