Diagnostic value of two-dimensional shear wave elastography in papillary thyroid microcarcinoma

Abstract

ObjectiveThe purpose of this study was to evaluate the predictability of two-dimensional shear wave elastography (2D-SWE) for papillary thyroid microcarcinoma (PTMC).Materials and methodsOne hundred and eighteen patients with 137 thyroid nodules (46 benign nodules, 91 malignant nodules) were included in this study who received conventional ultrasound (US) and 2D-SWE before fine-needle aspiration or surgery. The diagnostic performance was compared between US findings only and the combined use of US findings with 2D-SWE, which were correlated with pathology results.ResultsReceiver-operating characteristic curve analysis was performed to assess the diagnostic performance of 2D-SWE. Conventional US findings and 2D-SWE values were analyzed and compared between benign and malignant thyroid nodules. The mean values of SWE_mean, SWE_min, and SWE_max were 46.6±16.7, 26.2±9.5, and 73.6±18.1 kPa, respectively, in PTMC, which were significantly higher than those in benign tumors (27.8±12.4, 15.8±8.6, and 50.3±22.6 kPa, P<0.001). The optimal cut-off values of SWE_mean, SWE_min, and SWE_max for predicting malignancy were 34.5, 21.8, and 53.2 kPa, respectively. Taller than wide, micro-calcification, and SWE_mean were found to be independent risk factors for predicting PTMC. The overall sensitivity, specificity, accuracy, positive predictive value, and negative predictive value of combined conventional US features with 2D-SWE parameters were 95.7%, 94.5%, 94.9%, 89.8%, and 97.7%, respectively; these were superior to those of conventional US (89.1%, 90.1%, 89.9%, 82.0%, and 93.2%).ConclusionThe study indicates that the quantitative parameters of 2D-SWE are an independent predictive factor for diagnosing PTMC, which could provide valuable information when conventional US cannot give determinate results.

The diagnostic performance of shear wave speed (SWS) imaging for thyroid nodules with elasticity modulus and SWS measurement

“…In their study, the optimal cut-off values of E-max and E-mean with Young's elastic modulus for predicting malignancy were 53.2 kPa and 34.5kPa, respectively. The sensitivity, specificity, PPV, NPV was 82.1%, 62.3%, 52.1%, 86.4% for E-max, while 83.7%, 77.4%, 63.3%, 89.7% for E-mean [25]. However, in our study, the cut off values were lower than above studies.…”

Value of contrast-enhanced ultrasound combined with elastography in evaluating cervical lymph node metastasis in papillary thyroid carcinoma

“…Currently, there are few studies on the relationship between elastography and PTC cervical lymph node metastasis. Duan et al[27] believed that the elasticity score of cervical lymph nodes was positively correlated with hardness, and the higher the score, the greater the possibility of metastasis. Xu et al[23] revealed the accuracy of acoustic radiation force impulse in predicting cervical lymph node metastasis.…”

Elastography for the evaluation of thyroid nodules in pediatric patients

“…If larger studies confirm our results, elastography might allow children with elastic thyroid nodules to be placed in follow-up without invasive procedures or unnecessary thyroidectomies. However, the accuracy of elastography is limited by intra- and inter-operator variability ( 26 , 27 ) , which could be minimized by using SWE techniques ( 28 ) . Unlike strain elastography, SWE is a quantitative technique that is not operator-dependent, which avoids the limitations of strain elastography in evaluations of the head and neck, including the thyroid.…”