Comparison of Diagnostic Value of Conventional Ultrasonography and Shear Wave Elastography in the Prediction of Thyroid Lesions Malignancy

Abstract

IntroductionThyroid nodular disease (TND) is a very common disorder. However, since the rate of malignancy is reported to be 3-10%, only a minority of patients require aggressive surgical treatment. As a result, there is a need for diagnostic tools which would allow for a reliable differentiation between benign and malignant nodules. Although a number of conventional ultrasonographic (US) features are proved to be markers of malignancy, Shear Wave Elastography (SWE) is considered to be an improvement of conventional US. The aim of this study was to compare conventional US markers and SWE diagnostic values in the differentiation of benign and malignant thyroid nodules.Materials and MethodsAll patients referred for thyroidectomy, irrespective of the indications, underwent a US thyroid examination prospectively. Patients with TND were included into the study. Results of the US and SWE examinations were compared with post-surgical histopathology. ResultsOne hundred and twenty two patients with 393 thyroid nodules were included into the study. Twenty two patients were diagnosed with cancer. SWE turned out to be a predictor of malignancy superior to any other conventional US markers (OR=54.5 using qualitative scales and 40.8 using quantitative data on maximal stiffness with a threshold of 50 kPa). ConclusionsAlthough most conventional US markers of malignancy prove to be significant, none of them are characterized by both high sensitivity and specificity. SWE seems to be an important step forward, allowing for a more reliable distinction of benign and malignant thyroid nodules. Our study, assessing SWE properties on the highest number of thyroid lesions at the time of publication, confirms the high diagnostic value of this technique. It also indicates that a quantitative evaluation of thyroid lesions is not superior to simpler qualitative methods.

Shear Wave Elastography Combining with Conventional Grey Scale Ultrasound Improves the Diagnostic Accuracy in Differentiating Benign and Malignant Thyroid Nodules

“…Other studies suggested that SWE was useful in differentiating benign and malignant thyroid nodules when the cut-off level of 66 kPa and 65 kPa for E maximum were used, respectively [15,36]. However, Szczepanek-Parulska et al [37] found that the threshold value of 50 kPa for E maximum was the most useful SWE parameter in the differentiation of benign and malignant nodules. Using the cut-off value of ≥53.2 kPa for E maximum ≥ 34.5 kPa for E mean and ≥21.8 kPa for E minimum , Duan et al [33], found that SWE was superior to conventional GSU in identifying malignant nodules.…”

Jak typować guzy do biopsji aspiracyjnej cienkoigłowej w wolu wieloguzkowym? Rola konwencjonalnej ultrasonografii oraz elastografii fali poprzecznej — badanie pilotażowe

“…The patients with MNG were selected from a group of subjects referred for thyroidectomy between August and December 2010, irrespectively of indications for surgery, described previously [19]. All patients underwent thyroid US and SWE examination prospectively before surgery.…”

Penile masses: Shear Wave Elastography correlated with Magnetic Resonance Imagining. A two cases report.

“…However, due to the long examination time and higher costs, it is not possible to use MRI in daily practice. Shear wave elastography (SWE) is a novel imaging modality, which could give quantitative information regarding the stiffness of tissues and is found effective in the diagnosis of several pathologies including liver fibrosis and malignancies of the breast, thyroid and prostate [3,4] In this paper we will present two cases with penile masses which were evaluated by SWE in addition to MRI to show the possible role of SWE in the differentiation of benign and malignant masses.…”