Use of strain ultrasound elastography versus fine-needle aspiration cytology for the differential diagnosis of thyroid nodules: a retrospective analysis

Yang, Xianghua; Zhai, Dong-Cai; Zhang, Tao; Zhang, Shenjie

doi:10.6061/clinics/2020/e1594

Cited by 6 publications

(4 citation statements)

References 18 publications

(29 reference statements)

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“…This aligned with the results of many studies, demonstrating that ultrasound findings using TI-RADS reporting can predict the thyroid FNAC with reasonable specificity and sensitivity. 8 , 9 Ultrasonography reliably classifies thyroid nodules, and thus can assist in the decision-making of whether to proceed for a thyroid FNAC. 9 This was in concordance with the result of ARC TI-RADS obtained in this study: ACR TI-RADS-3 (20.8%), ACR TI-RADS-4 (39.2%) and ACR TI-RADS-5 (87.5%).…”

Section: Discussionmentioning

confidence: 99%

“… 7 A thyroid ultrasound enhances the ability to manage thyroid nodule disorders by diagnosing nonpalpable thyroid nodules. 8 Besides offering reliable classification of thyroid nodules that assists in the decision-making regarding the need for biopsy and directing the fine needle to target the most suspicious area of the nodule. 9 Sonography-guided FNAC improves the accuracy and safety of the technique for diagnosing thyroid nodules.…”

Section: Introductionmentioning

confidence: 99%

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The prevalence and associated predictors for Bethesda III–VI for reporting thyroid cytopathology in Royal Commission Hospital, Kingdom of Saudi Arabia

Alyousif

Adam

Alamin

et al. 2022

Therapeutic Advances in Endocrinology

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Background: Thyroid cancer is increasing globally and is currently the most prevalent endocrine malignancy. Recent data show an increase in the incidence of thyroid cancer in the Kingdom of Saudi Arabia (KSA). Thyroid ultrasound and fine-needle aspiration cytology (FNAC) are the cornerstones in managing thyroid nodules. We conducted this study to evaluate the prevalence and the associated predictors for thyroid nodule Bethesda III–VI in eastern KSA. Methods: A retrospective study was conducted between January 2015 and 31 August 2021. The participants were recruited patients who received a thyroid ultrasound and ultrasound-guided thyroid FNAC, using the thyroid imaging reporting and data system (TI-RADS) and the Bethesda Classification, respectively. Result: Three hundred and ten patients who underwent thyroid FNAC were enrolled in the study. The median (interquartile, IQR) age was 47.0 (20.0) years, and 266 (85.8%) of them were females. The median (IQR) body mass index was 30.2 (7.6) kg/m2. Out of these participants, 64.8% were euthyroid, 27.4% had hypothyroidism and 7.7% had hyperthyroidism. The ACR TI-RADS-3, 4 and 5 were 51.3%, 46.1% and 2.6%, respectively. The Bethesda outcome of thyroid FNAC I–VI was 5.2%, 63.9%, 15.5%, 5.8%, 3.5% and 6.1%, respectively. The risk for malignancy (Bethesda III–VI) was documented in 31.0% and atypia of undetermined significance was most prevalent (15.5%). A higher ACR TI-RADS score was associated with a higher risk of malignancy: ACR TI-RADS-3 (20.8%), ACR TI-RADS-4 (39.2%) and ACR TI-RADS-5 (87.5%). In a multivariate analysis, only the ACR TI-RADS score was significantly associated with the outcome of thyroid FNAC: ACR TI-RADS-4 [OR = 2.59 (95% CI = 1.54–4.36)] and ACR TI-RADS-5 [OR = 29.03 (95% CI = 3.44–245.07)]. Conclusion: There was a high prevalence of Bethesda III–VI and atypia of undetermined significance was most prevalent. A thyroid ultrasound report for TI-RADS was significantly associated with the outcome of thyroid FNAC and is a reliable tool in the absence of molecular testing for thyroid cancer.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

The prevalence and associated predictors for Bethesda III–VI for reporting thyroid cytopathology in Royal Commission Hospital, Kingdom of Saudi Arabia

Alyousif

Adam

Alamin

et al. 2022

Therapeutic Advances in Endocrinology

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“…It helps improve the prognosis of patients and the attainment of pCR. However, some previous studies[ 5 - 7 ] have found significant differences in the pathological response of individuals after NAC. The diagnosis of pathological remission is of great significance for individualized treatment and prognosis.…”

Section: Discussionmentioning

confidence: 90%

Preoperative neoadjuvant chemotherapy in patients with breast cancer evaluated using strain ultrasonic elastography

Pan¹,

Zhang²,

Wu³

et al. 2022

WJCC

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BACKGROUND The incidence of breast cancer in China is increasing while its mortality rate is decreasing. The annual breast cancer incidence in China is 39.2 million, accounting for two-thirds of the urban population. In China, breast cancer is the fifth most common malignant tumor overall and the most common in women, accounting for 17% of female malignant tumors. AIM To investigate the accuracy of strain ultrasound elastography (SUE) on the evaluation of preoperative neoadjuvant chemotherapy (NAC) in breast cancer. METHODS Overall, 90 patients with breast cancer treated at our hospital between January 2018 and February 2019 were selected for this study. The patients received six cycles of NAC with docetaxel, epirubicin, and cyclophosphamide. Surgical treatment was also performed, and pathological reactivity was assessed. The patients were evaluated using conventional ultrasonography and SUE before biopsy. The differences between groups were analyzed to calculate the mean and standard deviation with significance measured using a t -test, while multivariate analysis was performed using logistic regression analysis. RESULTS Of the patients analyzed, 20 had a pathological complete remission (pCR) while 70 did not achieve pCR after NAC. The ratio of the elastic strain ratio (SR) and elastic score of 4–5 in patients with pCR were 5.5 ± 1.16 and 15.00%, respectively; these were significantly lower than those in patients without pCR (85%) and significantly higher than in patients without pCR (14%). SR and elastic score 4–5 were independent factors influencing NAC efficacy (OR=0.644, 1.426 and 1.366, respectively, P < 0.05). SR was positively correlated with elasticity score (r s = 0.411, P < 0.05). The area under the receiver operator characteristic curve of SR and SR combined with elastic score in predicting patients without pCR was 0.822 and 0.891, respectively ( P < 0.05). CONCLUSION Strain ultrasonic elastography may be used to evaluate the effects of preoperative NAC in patients with breast cancer.

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“…The authors underline the significant usefulness of strain ultrasound elastography in detecting a thyroid papillary carcinoma due to its stiffness. It is suspected, however, that other malignant tumors may have different elasticities [ 41 ]. The results of the study are consistent with the work of Hairu et al, who investigated the diagnostic efficiency of elastography and ATA guidelines in the adult population.…”

Section: Discussionmentioning

confidence: 99%

Suspected Malignant Thyroid Nodules in Children and Adolescents According to Ultrasound Elastography and Ultrasound-Based Risk Stratification Systems—Experience from One Center

Borysewicz-Sańczyk

Sawicka

Karny

et al. 2022

JCM

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The risk of malignancy in thyroid nodules correlates with the presence of ultrasonographic features. In adults, ultrasound risk-classification systems have been proposed to indicate the need for further invasive diagnosis. Furthermore, elastography has been shown to support differential diagnosis of thyroid nodules. The purpose of our study was to assess the application of the American Thyroid Association (ATA), British Thyroid Association (BTA) ultrasound risk-classification systems and strain elastography in the management of thyroid nodules in children and adolescents from one center. Seventeen nodules with Bethesda III, IV, V and VI were selected from 165 focal lesions in children. All patients underwent ultrasonography and elastography followed by fine needle aspiration biopsy. Ultrasonographic features according to the ATA and BTA stratification systems were assessed retrospectively. The strain ratio in the group of thyroid nodules diagnosed as malignant was significantly higher than in benign nodules (6.07 vs. 3.09, p = 0.036). According to the ATA guidelines, 100% of malignant nodules were classified as high suspicion and 73% of benign nodules were assessed as low suspicion. Using the BTA U-score classification, 80% of malignant nodules were classified as cancerous (U5) and 20% as suspicious for malignancy (U4). Among benign nodules, 82% were classified as indeterminate or equivocal (U3) and 9% as benign (U2). Our results suggest that application of the ATA or BTA stratification system and elastography may be a suitable method for assessing the level of suspected malignancy in thyroid nodules in children and help make a clinical decision about the need for further invasive diagnosis of thyroid nodules in children.

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Use of strain ultrasound elastography versus fine-needle aspiration cytology for the differential diagnosis of thyroid nodules: a retrospective analysis

Cited by 6 publications

References 18 publications

The prevalence and associated predictors for Bethesda III–VI for reporting thyroid cytopathology in Royal Commission Hospital, Kingdom of Saudi Arabia

The prevalence and associated predictors for Bethesda III–VI for reporting thyroid cytopathology in Royal Commission Hospital, Kingdom of Saudi Arabia

Preoperative neoadjuvant chemotherapy in patients with breast cancer evaluated using strain ultrasonic elastography

Suspected Malignant Thyroid Nodules in Children and Adolescents According to Ultrasound Elastography and Ultrasound-Based Risk Stratification Systems—Experience from One Center

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