Grayscale ultrasound and strain elastography in the characterization of thyroid nodule in correlation with fine-needle aspiration cytology

Abstract

Background: Thyroid nodule(s) is a common clinical problem, because of high risk of malignancy in some of these nodules it is mandatory to establish a thyroid scoring system for nodule characterization and subjecting the highly suspicious and sizable nodules to fine-needle aspiration cytology (FNAC). Objectives: The aim of this study was to evaluate the role of thyroid imaging reporting and data system (TIRADS) and thyroid strain elastography in the assessment of thyroid nodules and correlating the results with FNAC. Methods: This is a prospective study that includes 30 patients referred to the ultrasound unit in oncology teaching hospital, medical city, Baghdad, having anterior neck mass in thyroid gland location, during the period from the beginning of September 2018 to October 2019. Results: The thirty patients in the study sample consists of 25 females and 5 males, most of them are in the fourth decade (43%), the majority of detected thyroid nodules are either solid, isoechoic or hyperechoic in comparison to thyroid gland and hence had 3 points and scored as TIRADS 3, this was seen in 12 patients (40%), the least detected nodules are the highly suspicious one was irregular, with microcalcification, being very hypoechoic, given score 10 and by that categorized as TIRADS 5, this seen in 4 patients (13.3%), When we correlate the TIRADS scoring, elasto scoring and elasto ratio with FNAC results we found a significant correlation between the TIRADS score and FNAC with P value of 0.012, significant correlation also seen between the elasto scan and FNAC results P-value = 0.002475, while the correlation between the elasto ratio and FNAC was not significant, P-value =0.8. Conclusion:The TIRADS as a scoring system is an important reliable method for characterizing of thyroid nodule, the elasto score is also beneficial in evaluating the nodule when performed by professional personal, however the using of elasto ratio is not always beneficial.