Elastography for the evaluation of thyroid nodules in pediatric patients

Cunha, Gustavo Bittar; Marino, Luciana Cristante Izar; Yamaya, Andre Carvalho; Kochi, Cristiane; Monte, Osmar; Longui, Carlos Alberto; Cury, Adriano Namo; Fleury, Eduardo de Faria Castro

doi:10.1590/0100-3984.2018.0034

Cited by 9 publications

(9 citation statements)

References 29 publications

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“…In parallel, with their recent study Cunha et al evaluated the usefulness of strain elastography as an additional diagnostic tool for children who present with thyroid nodules. The authors found that the high elasticity of a nodule on elastography was associated with a low risk of thyroid cancer [33]. In agreement with them, Borysewicz-Sanczyk et al found elastography to have a high negative predictive value for a benign diagnosis, by analyzing a total of 62 thyroid nodules in 47 children and adolescents [38].…”

Section: Us Elastographymentioning

confidence: 69%

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Imaging and Imaging-Based Management of Pediatric Thyroid Nodules

Iakovou

Giannoula

Sachpekidis

2020

JCM

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Thyroid nodules are less frequent in children than adults. Childhood thyroid nodules carry specific features, including a higher risk of malignancy than nodules in adults, rendering them unique in terms of management. Subsequently, they should be considered a distinct clinical entity with specific imaging recommendations. Initial evaluation requires a thorough workup, including clinical examination, and a detailed personal and familial history to determine the presence of possible risk factors. Laboratory and radiologic evaluation play an integral part in the diagnostic algorithm, with ultrasonography (US) being the first diagnostic test in all patients. US elastography has been recently introduced as an incremental method, reducing the subjectivity of the clinical diagnosis of nodule firmness associated with increased malignancy risk. However, fine-needle aspiration biopsy (FNAB) remains the mainstay in the diagnostic work-up of thyroid nodules and is documented to be best method for differentiating benign from malignant thyroid nodules. In addition, thyroid scintigraphy provides functional imaging information, which has a role both in the diagnostic management of thyroid nodules and during follow up in malignancies. Finally, despite providing additional information in certain clinical scenarios, 18F-fludeoxyglucose Positron Emission Tomography (18F-FDG-PET), computed tomography (CT), and magnetic resonance imaging (MRI) imaging are not routinely recommended for the evaluation of patients with newly detected thyroid nodules or in all cases of thyroid cancer. The objective of this review is to summarize the concepts in imaging and imaging-based management of nodular thyroid disease in the pediatric population, acknowledging the unique features that this patient group carries and the specific approach it requires.

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Section: Us Elastographymentioning

confidence: 69%

“…The strain ratio is calculated automatically, and a higher strain ratio translates to a higher probability of malignancy. Another form of evaluating the elastography data is by calculating the thyroid strain ratio to perform an objective, semi-quantitative analysis of the tissue stiffness [33].…”

Section: Us Elastographymentioning

confidence: 99%

Imaging and Imaging-Based Management of Pediatric Thyroid Nodules

Iakovou

Giannoula

Sachpekidis

2020

JCM

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“…Normal thyroid tissue elasticity in children was previously assessed [ 16 ]. However, very few studies have reported the use of elastography to assess thyroid nodules in children [ 17 , 18 ], and, to the best of our knowledge, none have yet studied the use of SWE specifically for differentiating benign and malignant thyroid nodules in the pediatric population.…”

Section: Introductionmentioning

confidence: 99%

Accuracy of shear wave elastography in characterization of thyroid nodules in children and adolescents

et al. 2021

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Background Thyroid nodules are an important health problem in children and adolescents. They possess a higher risk of malignancy in comparison to adults. This fact forms a great dilemma for clinicians. The aim of this study was to evaluate the reliability of shear wave elastography (SWE) as a non-invasive technique in the characterization of thyroid nodules in children and adolescents. Methods This prospective study included 56 patients with thyroid nodules. All the patients underwent clinical assessment, laboratory investigations, ultrasound, and Doppler examination, followed by an SWE assessment. Statistical analysis was performed and the best cut-off value to differentiate benign from malignant nodules was determined using the ROC curve and AUC. Results Seventy-two nodules were detected in the examined patients (ages ranged from 11 to 19 years, with mean age of 14.89 ± 2.3 years). Fifty-eight nodules (80.6%) were benign, and fourteen nodules (19.4%) were malignant (histopathologically proved). Highly suspicious criteria for prediction of malignancy by ultrasound and Doppler were hypoechoic echopattern, internal or internal and peripheral vascularity, microcalcifications, taller-than-wide dimensions, irregular outlines, and absence of halo (p < 0.05). The diagnostic performance for their summation was 70.69% sensitivity, 82.8% specificity, 80.45% accuracy, a 63.79% positive predictive value (PPV), and 87.9% negative predictive values (NPV). Regarding SWE, our results showed that 42.2 kPa was the best cut-off value, with AUC = 0.921 to differentiate malignant from benign nodules; the diagnostic performance was 85.71% sensitivity, 94.83% specificity, 93.06% accuracy, 76.9% PPV, and 93.2% NPV. Conclusion Shear wave elastography is a non-invasive technique that can assist in the diagnosis of malignant thyroid nodules among children and adolescents.

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“…Accordingly, a nodule whose Young's modulus exceeds 65 kPa is usually considered suspicious 1 . More than 100 articles concerned with the detection of thyroid disease using various elastographic methods (mainly static, ARFI and SWE 3 ) have been published since 2005 [4][5][6] . One report even took advantage of the waves generated by carotid movements for passive applications 7 .…”

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confidence: 99%

Natural shear wave imaging using vocal tract vibrations: Introducing vocal passive elastography (V-PE) to thyroid elasticity mapping

Beuve

Callé

Khoury

et al. 2021

Applied Physics Letters

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We present a shear wave elastography approach for thyroid characterization that is inspired by passive elastography which extracts elasticity from the natural vibrations in living tissues that are caused by cardiac motion, blood pulsatility and muscle activity. On thyroid, this physiological noise is mainly due to the carotid pulsation which is in the 1-10 Hz bandwidth and is located right next to the gland. In order to decrease the shear wavelength and increase the signal to noise ratio, we propose to create in the thyroid a complex shear wave field by using natural vocal tract vibrations. The nature of the sound can be easily modified to be narrow or broad band, with small or large amplitude. Using correlation based algorithm and a sound sustained at 150 Hz, we have developed an innovative technique using ultrasound, allowing us to compute a 2D shear wave velocity map, superposed onto a B-mode ultrasound image of a volunteer's thyroid. Using our Vocal Passive Elastography (V-PE) method, shear wave velocity was measured at every point within a mask surrounding the thyroid with a pixel resolution of 150×150 µm 2 . The mean shear wave speed value measured is 3.2 m/s, taking its value from 0.7 m/s to 8.8 m/s. The values obtained were in good agreement with comparative Shear Wave Elastography (SWE) measurements.

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Elastography for the evaluation of thyroid nodules in pediatric patients

Cited by 9 publications

References 29 publications

Imaging and Imaging-Based Management of Pediatric Thyroid Nodules

Imaging and Imaging-Based Management of Pediatric Thyroid Nodules

Accuracy of shear wave elastography in characterization of thyroid nodules in children and adolescents

Natural shear wave imaging using vocal tract vibrations: Introducing vocal passive elastography (V-PE) to thyroid elasticity mapping

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