Diagnostic Accuracy of Elastography in Differentiating Benign from Malignant Thyroid Nodules Taking Fine Needle Aspiration Cytology as Gold Standard

Abstract

Objective: To evaluate the diagnostic accuracy of Strain Elastography in differentiating benign from malignant thyroid nodules taking fine needle aspiration cytology as gold standard. Study Design and Setting: It was a cross sectional study conducted at Radiology department of Jinnah Postgraduate Medical Centre, Karachi from May 2019 to June 2020 Methodology: Total 586 patients with complaints of swelling in region of thyroid gland were enrolled in study on which Strain Elastography was performed using linear transducer with ultrasound frequency of 7.5 MHz. The results of strain Elastography were compared with histopathology. All the information was recorded into predesigned proforma. Chi-square test was used for comparison among categorical variables and when it has not worked then imitation of Monte Carlos was applied and to see agreement among various categorical variables Kappa statistics were performed. Level of statistical significance was accepted as P < 0.05. Results: The sensitivity of 100%, specificity of 80.2%, positive predictive value of 61.7%, negative predictive value of 100%, and diagnostic accuracy of 85% of elastography was calculated in differentiation among benign from malignant thyroid nodules. Conclusion: Strain elastography is noninvasive technique which can be used to characterize thyroid nodules and helps in differentiating benign from malignant thyroid nodules and can limit the utilization of invasive technique like FNAC and helps in selection of patients which needs surgery.

Age Related Cytoarchitectural Comparison of Histopathological Changes in Thyroid Nodule

“…Literature review of FNAC findings showed that the study conducted by Agrawal and colleagues found sensitivity 88.8%, specificity 100%, PPV 100% and NPV 95.12% 24 while Jesrani et al, in their elastographic study of benign and malignant thyroid nodules perceived, sensitivity100%, specificity 80.2%, PPV 61.7%, NPV 100% and accuracy 85%. 25 These results are in favour of our study findings for FNAC of thyroid nodules except for the sensitivity which is at a little lower side in our observations. The main limitation is that it was single centered study conducted on small group of population so results could not be generalized in relation to ethnicity.…”