Comparison of Elastographic Strain Index and Thyroid Fine-Needle Aspiration Cytology in 631 Thyroid Nodules

Thyroid elastography has become, lately, one of the main focuses in thyroid imaging. With more than one hundred papers published on this subject, the core of accumulated knowledge justifies the need for a comprehensive review on the topic. The paper presents the various elastographic techniques used for thyroid assessment. Both strain and shear wave elastography, with all their variants, are discussed. Thereafter the paper proceeds to a detailed description of the technical peculiarities, diagnostic value, limitations and pitfalls for each technique. Although the main accent is placed on thyroid nodules, the applications of elastography in other thyroid disease, diffuse or focal, are also presented. The results of the available metaanalyses are reviewed and the proven value of the technique is highlighted. Still unanswered questions and directions for future research are emphasized, whenever appropriate.

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“…A cutoff value >2.905 produced greater sensibility and negative predictive value than grey scale criteria [76].…”

Section: Limitations and Causes Of False Results For Srmentioning

confidence: 87%

Ultrasound elastography in thyroid disease

Dudea

Botar-Jid

2015

Med Ultrason

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“…In our previously published study, we reported that tissue stiffness measured by strain elastography is an independent predictor of TC (Azizi et al 2013). Several studies showed that this technology can play an important role in TN selection and risk assessment for malignancy before FNAB (Bhatia et al 2011;Friedrich-Rust et al 2013;Magri et al 2013;Rivo-V azquez et al 2013).…”

Section: Introductionmentioning

confidence: 92%

Thyroid Nodules and Shear Wave Elastography: A New Tool in Thyroid Cancer Detection

Azizi

Keller²,

Mayo

et al. 2015

Ultrasound in Medicine & Biology

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This study determines the performance of virtual touch imaging quantification (VTIQ), a non-invasive shear wave elastography method for measuring thyroid nodule (TN) stiffness, in distinguishing benign from malignant TNs. This prospective study evaluates 707 TNs in 676 patients with fine-needle aspiration biopsy (FNAB). Before FNAB, both conventional B-mode ultrasound and shear wave elastography were performed. Surgical resection was recommended for FNAB results that were not clearly benign. Surgical pathology confirmed 82 malignant TNs. The receiver operating curve identified a single cut-off of 3.54 m/s as the maximum shear wave velocity (SWV) for predicting thyroid cancer (TC). The sensitivity and specificity were 79.27% and 71.52%, respectively. Positive predictive value (PPV) was 26.75% and negative predictive value (NPV) was 96.34%. Compared with B-mode US features for predicting malignancy, SWV ≥3.54 m/s has a higher sensitivity, specificity, PPV and NPV. TN stiffness measured by VTIQ-generated shear wave elastography is an independent predictor of TC.

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“…It is possible that our sample of 35 subjects was insufficiently large to show weak associations that exist; alternatively, given the mixed findings in the literature, it is possible that these findings are specific to particular patient cohorts and therefore not applicable to our subject population. Among the relatively newer diagnostic methods, genetic markers (32,(41)(42)(43)(44) and US elastography (33)(34)(35)(45)(46)(47)(48)(49)(50)(51)(52)(53)(54)(55)(56)(57)(58)(59)(60) have been evaluated. A new molecular test, Afirma (Veracyte, South San Francisco, Calif) has shown promise for preoperative malignancy risk stratification for these nodules (32).…”

Section: Swe Findingsmentioning

confidence: 99%