Diagnostic performance of C-TIRADS combined with SWE for the diagnosis of thyroid nodules

Abstract

ObjectiveTo explore the value of the optimal parameters of shear wave elastography (SWE) to enhance the identification of benign and malignant thyroid nodules by C-TIRADS.MethodsThe two-dimensional ultrasonography images and SWE images of 515 patients with a total of 586 thyroid nodules were retrospectively analyzed. The nodules were divided into the D ≤10 mm and D >10 mm groups according to size and were graded by C-TIRADS. With the pathological results as the gold standard, the receiver operating characteristic (ROC) curves were drawn, and the area under the curve (AUC) was calculated to compare the diagnostic performances of C-TIRADS, SWE, and the combination of the two on the benign and malignant thyroid nodules.ResultsThe ROC showed that the AUC of the maximum elastic modulus (0.875) was higher than that of the mean elastic modulus (0.798) and elasticity ratio (0.772), with an optimal cutoff point of 51 kPa, which was the optimal parameter to distinguish the malignant from the benign nodules (P < 0.001). In the D ≤10 mm group, the AUC of TIRADS combined with SWE (0.955) was elevated by 0.172 compared with the application of C-TIRADS alone (0.783), and the difference was statistically significant (P < 0.05). In the D >10 mm group, the AUC of TIRADS combined with SWE (0.904) was elevated by 0.076 compared with the application of C-TIRADS alone (0.828), and the difference was statistically significant (P < 0.05). Among all nodules, the application of C-TIRADS alone had a sensitivity of 88.14%, a specificity of 74.56%, and an accuracy of 85.50% in diagnosing benign and malignant thyroid nodules, while the sensitivity, specificity, and accuracy were 93.22%, 90.35%, and 92.66%, respectively, in combination with SWE.ConclusionThe diagnostic performance of SWE in combination with TIRADS was better than that of SWE or C-TIRADS alone. Here, SWE enhanced the diagnostic performance of C-TIRADS for the benign and malignant thyroid nodules, most significantly for nodules with D ≤10 mm.

Incorporation of CEUS and SWE Parameters into a Multivariate Logistic Regression Model for the Differential Diagnosis of Benign and Malignant TI-RADS4 Thyroid Nodules

“…The hardness of nodules has been positively correlated with the degree of malignancy, and the higher the maximum Young's modulus of a nodule is, the higher the malignancy risk [22]. The diagnostic cutoff values for thyroid nodules vary between studies [23,24], so no standard diagnostic cutoff value of Young's modulus for thyroid nodules has been de ned in guidelines. In this study, Emax had the highest diagnostic e cacy [AUC=0.816, vs. Emean (AUC=0.763) and Esd (AUC=0.687)], with a diagnostic cutoff value of 36.00 kPa, sensitivity of 72.90%, speci city of 79.40%, and accuracy of 75.00%, similar to the results of Zhao [25].…”

Incorporation of CEUS and SWE parameters into a multivariate logistic regression model for the differential diagnosis of benign and malignant TI-RADS 4 thyroid nodules

“…The hardness of nodules has been positively correlated with the degree of malignancy, and the higher the maximum Young’s modulus of a nodule is, the higher the malignancy risk [ 25 ]. The diagnostic cutoff values for thyroid nodules vary between studies [ 26 , 27 ], so no standard diagnostic cutoff value of Young’s modulus for thyroid nodules has been defined in guidelines. In this study, Emax had the highest diagnostic efficacy [AUC = 0.816, vs. Emean (AUC = 0.763) and Esd (AUC = 0.687)], with a diagnostic cutoff value of 36.00 kPa, sensitivity of 72.90%, specificity of 79.40%, and accuracy of 75.00%, similar to the results of Zhao [ 28 ].…”

“…The cutoff value of Emax in this study was far higher than that (18.2 kPa) in the study of Petersen [ 29 ] and far lower than that (115 kPa) in the study of Mena [ 30 ]. This may be due to the following two reasons: 1) due to the possible difference in diagnostic parameters between different brands of machines; 2) because only category 4 nodules were selected for this sample and because category 4 nodules were less likely to have nodules with calcification in this sample, there is a study that suggests that SWE should be used to avoid measurement of calcification in the process of measuring [ 26 ]. Zhang [ 31 ] also found that both the sensitivity and accuracy of SWE combined with ACR TI-RADS for the diagnosis of thyroid nodules were greatly improved.…”

Elastografie von Schilddrüsenknoten

“…Für alle Knoten hatte K-TI-RADS allein eine Sensitivität von 88%, Spezifität von 74% und Genauigkeit von 85% in der Unterscheidung von benignen und malignen Knoten, während in Kombination mit der SWE sich Werte von 93%, 90% und 92% zeigten. Die AUC war für die Kombination beider Methoden (0,918) signifikant höher als für K-TI-RADS oder SWE allein [53].…”