Practical Application of Elastography in the Diagnosis of Thyroid Nodules in Children and Adolescents

Abstract

Background: Ultrasound elastography is a noninvasive method of imaging based on the estimation of the mechanical properties of tissue. Data in adults indicate that decreased flexibility in comparison to the surrounding healthy tissue is characteristic of malignancy (in most thyroid carcinomas, except for follicular thyroid carcinoma). The purpose of our study was to assess the deformation of thyroid nodules and to evaluate the usefulness of elastography in predicting malignant thyroid nodules in adolescent patients. Methods: We examined 47 children with 62 thyroid nodules. All patients underwent elastography and fine needle aspiration cytology (FNAC). Results: Thirty-seven girls (79%) and 10 boys (21%) were included in the study. A strain ratio <2 was observed in 17 nodules (27% of the study group), a strain ratio between 2 and 4.9 in 34 nodules (55%) and a strain ratio >5 in 11 nodules (18%). According to cytological examination, 3 nodules (4.8% of the study group) were malignant. Two of them were hard (strain ratio ≥5), and 1 nodule had a strain ratio of 2. Conclusions: Our results suggest that elastography can be complementary to conventional ultrasonography and useful while making a decision about FNAC. At the same time, it should not replace the cytological assessment of thyroid nodules in children and adolescents.

Imaging and Imaging-Based Management of Pediatric Thyroid Nodules

“…The authors found that the high elasticity of a nodule on elastography was associated with a low risk of thyroid cancer [33]. In agreement with them, Borysewicz-Sanczyk et al found elastography to have a high negative predictive value for a benign diagnosis, by analyzing a total of 62 thyroid nodules in 47 children and adolescents [38]. Such studies suggest that the method may prove useful as a complementary test for screening thyroid nodules in children.…”

Elastography for the evaluation of thyroid nodules in pediatric patients

“…In one recent study, Borysewicz-Sanczyk et al. ( 25 ) employed elastography in their analysis of a total of 62 thyroid nodules in 47 children and adolescents: 37 females (age range, 9-18 years) and 10 males (age range, 7-17 years). The authors found elastography to have a high negative predictive value for a benign diagnosis.…”

Rekomendacje Polskich Towarzystw Naukowych „Diagnostyka i leczenie raka tarczycy”. Aktualizacja na rok 2018

“…SoR: G1; QoE: + / PolCon 62/62 5.6. Elastography may be helpful in the selection of a lesion for FNAB; however, it is not obligatory [10][11][12][13][14] SoR: G1; QoE: PolCon 62/62 6. Indications for FNAB after diagnosis of thyroid lesion by other imaging modalities.…”