In this prospective study, the diagnostic value of real-time ultrasound elastography (USE) was evaluated in 51 consecutive patients referred for surgical treatment with single solid thyroid nodules < 10 mm in maximum diameter with an indeterminate result on B-mode and colour Doppler ultrasonography. Ultrasonographic results were compared with histopathological data. Nineteen follicular adenomas and 32 papillary thyroid microcarcinomas (PTMCs) were observed. A real-time USE score of 4 − 5 diagnosed PTMCs with a sensitivity of 90.63%, a specificity of 89.47% and an accuracy of 90.20%. The positive and negative predictive values were 93.55% and 85.00%, respectively. It is concluded that real-time USE is a promising imaging technique that could assist in the differential diagnosis of single solid thyroid nodules < 10 mm in maximum diameter that give indeterminate results on conventional ultrasound.
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