Diagnostic Performance of a Combination of Shear Wave Elastography and B-Mode Ultrasonography in Differentiating Benign From Malignant Thyroid Nodules

Abstract

Objectives. This study was conducted to compare clinicopathologic and radiologic factors between benign and malignant thyroid nodules and to evaluate the diagnostic performance of shear wave elastography (SWE) combined with Bmode ultrasonography (US) in differentiating malignant from benign thyroid nodules.Methods. This retrospective study included 92 consecutive patients with 95 thyroid nodules examined on B-mode US and SWE before US-guided fine-needle aspiration biopsy or surgical excision. B-mode US findings (composition, echogenicity, margin, shape, and calcification) and SWE elasticity parameters (maximum [Emax], mean, minimum, and nodule-to-normal parenchymal ratio of elasticity) were reviewed and compared between benign and malignant thyroid nodules. The diagnostic performance of B-mode US and SWE for predicting malignant thyroid nodules was analyzed. The optimal cutoff values of elasticity parameters for identifying malignancy were determined. Diagnostic performance was compared between B-mode US only, SWE only, and the combination of B-mode US with SWE.Results. On multivariate logistic regression analysis, age (odds ratio [OR], 0.90; P =0.028), a taller-than-wide shape (OR, 11.3; P =0.040), the presence of calcifications (OR, 15.0; P =0.021), and Emax (OR, 1.22; P =0.021) were independent predictors of malignancy in thyroid nodules. The combined use of B-mode US findings and SWE yielded improvements in sensitivity, the positive predictive value, the negative predictive value, and accuracy compared with the use of B-mode US findings only, but with no statistical significance.

Shear Wave Elastography and Thyroid Imaging Reporting and Data System (TIRADS) for the Risk Stratification of Thyroid Nodules—Results of a Prospective Study

“…However, the accuracy of US for the differentiation between malignant and benign thyroid nodules remains unsatisfactory [ 7 , 28 ]. The introducing of sonoelastography in the clinical workup of thyroid nodules shows promising results for the differentiation of malignant and benign nodules [ 24 , 29 ].…”

Clinicopathological and Molecular Features of Secondary Cancer (Metastasis) to the Thyroid and Advances in Management

“…Elastography is a sonographic method of estimating tissue hardness that has been proposed to assist with differentiating benign from malignant thyroid lesions and evaluating optimal sites for biopsy [ 31 , 32 ]. In strain elastography, the stiffness of the lesion is compared to normal thyroid tissue through external compression.…”

“…Conversely, shear-wave elastography (SWE) estimates stiffness by measuring the velocity of wave propagation. However, there appears to be no statistically significant difference in diagnostic performance when using ultrasound combined with SWE compared to ultrasound alone to distinguish benign from malignant lesions [ 32 ]. Elastography is further limited by poorly defined cut-off values for interpreting stiffness.…”

Transcriptomic Analysis of Papillary Thyroid Cancer: A Focus on Immune-Subtyping, Oncogenic Fusion, and Recurrence

“…The incidence of thyroid cancer is increasing worldwide (1,2). Recently, the distinguishment between benign and malignant thyroid nodules is a very challenging problem, thus, methods of various clinical or experimental elements have been studied for increasing the accuracy (3).…”

“…The incidence of thyroid cancer is increasing worldwide [ 1 , 2 ]. Distinguishing between benign and malignant thyroid nodules is a very challenging problem; thus, studies have investigated various clinical and experimental methods to increase the accuracy [ 3 ]. Approximately 90% of thyroid cancers are differentiated thyroid carcinomas (DTCs), including the papillary and follicular types.…”