Real-time Elastography and Contrast-Enhanced Ultrasound for the Assessment of Thyroid Nodules

Friedrich‐Rust, Mireen; Sperber, A.; Holzer, Katharina; Diener, Justin; Grünwald, Frank; Badenhoop, Klaus; Weber, Sepp; Kriener, Susanne; Herrmann, Eva; Bechstein, Wolf O.; Zeuzem, Stefan; Bojunga, Jörg

doi:10.1055/s-0029-1237701

Cited by 107 publications

(93 citation statements)

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“…[18][19][20][21] Recent studies have evaluated the use of US elastography for detecting malignant thyroid nodules. [23][24][25][26][27][28][29][30][31][32] These uniformly suggest that US elastography increases the ability to discriminate benign and malignant nodules. Recently, Bojunga et al 31 published a meta-analysis of elastography for the differentiation of benign and malignant thyroid nodules, concluding that US elastography can be used with high sensitivity in the work-up of thyroid nodules and might be a useful method in addition to or even instead of FNAB to select patients for surgery.…”

Section: Discussionmentioning

confidence: 99%

“…Most publications referring to US elastography in the evaluation of thyroid nodules propose a scale of tissue stiffness based on the color of the elastograms: 4-point scales, [23][24][25][26] 5-point scales, 28 and 6-point scales. 24 Lyshchik et al 26 evaluated 52 thyroid nodules in 31 patients and found a specificity of 96% and a sensitivity of 82%.…”

Section: Discussionmentioning

confidence: 99%

“…The PPVs and NPVs were 55% and 98%, respectively. Friedrich-Rust et al 23 investigated 53 nodules in 50 patients and found an 86% sensitivity and an 87% specificity. Rago et al 28 found scales 4 -5 highly predictive of malignancy with a sensitivity of 97% and a specificity of 100%.…”

Section: Discussionmentioning

confidence: 99%

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Utility and Interobserver Agreement of Ultrasound Elastography in the Detection of Malignant Thyroid Nodules in Clinical Care

Merino¹,

Arrazola²,

Cárdenas³

et al. 2011

AJNR Am J Neuroradiol

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Utility and Interobserver Agreement of Ultrasound Elastography in the Detection of Malignant Thyroid Nodules in Clinical Care

Merino¹,

Arrazola²,

Cárdenas³

et al. 2011

AJNR Am J Neuroradiol

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“…Therefore, no statement on the diagnostic accuracy of SE for follicular carcinoma can be made. Previous studies have reported that both FNA and SE have difficulties in the diagnosis of follicular carcinoma [3, 16,27,38,46]. In a meta-analysis on SE including 8 studies, 44 % of follicular carcinoma were not detected as malignant thyroid nodules using SE.…”

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confidence: 97%

Evaluation of Strain Elastography for Differentiation of Thyroid Nodules: Results of a Prospective DEGUM Multicenter Study

et al. 2016

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▼Purpose: Many patients with thyroid nodules are presently referred to surgery for not only therapeutic but also diagnostic purposes. The aim of noninvasive diagnostic methods is to optimize the selection of patients for surgery. Strain elastography (SE) enables the ultrasound-based determination of tissue elasticity. The aim of the present study was to evaluate the value of SE for the differentiation of thyroid nodules in a prospective multicenter study. Materials and Methods: The study was registered at clinicaltrials.gov and was approved by the local ethics committees of all participating centers. All patients received an ultrasound (US) of the thyroid gland including color Doppler US. In addition, all nodules were evaluated by SE (Hitachi Medical Systems) using qualitative image interpretation of color distribution (SE-ES), strain value and strain ratio. Results: Overall, 602 patients with 657 thyroid nodules (567 benign, 90 malignant) from 7 centers were included in the final analysis. The sensitivity, specificity, NPV, PPV, +LR were 21 %, 73 %, 86 %, 11 %, 0.8, respectively, for color Doppler US; 69 %, 75 %, 94 %, 30 %, 2.9, respectively, for SE-ES; 56 %, 81 %, 92 %, 32 %, 2.9, respectively, for SEstrain value; and 58 %, 78 %, 92 %, 30 %, 2.6, respectively, for SE-strain ratio. The diagnostic accuracy was 71 % for both strain value and strain ratio of nodules. Conclusion: SE as an additional ultrasound tool improves the value of ultrasound for the workup of thyroid nodules. It might reduce diagnostic surgery of thyroid nodules in the future. Zusammenfassung ▼Ziel: Viele Patienten mit Schilddrüsenknoten werden nicht nur therapeutisch, sondern auch zu diagnostischem Zweck operiert. Ziel von nicht-invasiven diagnostischen Verfahren ist es daher die Selektion von Patienten zur Operation zu optimieren. Strain Elastografie (SE) ermöglicht die Ultraschall-basierte Messung der Gewebeelastizität. Das Ziel der vorliegenden Studie war es den Stellenwert der SE in einer prospektiven Multizenter-Studie für die Differenzierung von Schilddrüsenknoten zu evaluieren. Material und Methoden: Die Studie wurde bei clinicaltrials.gov registriert und von den lokalen Ethikkommissionen der teilnehmenden Zentren genehmigt. Alle Patienten erhielten einen Ultraschall (US) der Schilddrüse inklusive Farbduplex-US. Zusätzlich wurden alle Knoten mittels SE (Hitachi Medical System) untersucht und eine Beurteilung der qualitativen Farbverteilung (SE-ES) und eine semiquantitative Messung der Elastizität mittels strain value und strain ratio durchgeführt. Ergebnisse: Insgesamt wurden 602 Patienten mit 657 Schilddrüsenknoten (567 benigne, 90 maligne) an 7 deutschen Zentren ausgewertet. Sensitivität, Spezifität, NPV, PPV, und +LR betrugen entsprechend 21 %, 73 %, 86 %, 11 %, 0,8 für den Duplex-US; 69 %, 75 %, 94 %, 30 %, 2,9 für SE-ES; 56 %, 81 %, 92 %, 32 %, 2,9 für SE-strain value; 58 %, 78 %, 92 %, 30 %, 2,6 für SE-strain ratio. Die diagnostische Genauigkeit betrug 71 % sowohl für SEstrain value, als auch SE-strain ratio. Schlussfo...

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“…TIC parameters of shape have been assessed by Ferrari et al, 2008;Nemec et al, 2012and Giusti et al, 2013. Ferrari et al (2008 found that in malignant thyroid nodules wash-in and peak-enhancement occurred significantly faster than in benign mass lesions, whereas Nemec et al (2012), Friedrich-Rust et al (2010, and Giusti et al (2013) did not find a significant difference between the malign and benign nodules. In the Nemec's study, the relative intensity of the contrast enhancement was calculated rating the maximum enhancement against the base enhancement, with 84.4% sensitivity, 76.9% specificity and 82.6% diagnostic accuracy (Nemec et al, 2012).…”

Section: Discussionmentioning

confidence: 99%

Diagnostic Value of Contrast-Enhanced Ultrasound Evaluation of Malignant and Benign Solitary Thyroid Nodules

Prieditis

Radziņa

Štrumfa

et al. 2016

Proceedings of the Latvian Academy of Sciences. Section B. Natural, Exact, and Applied Sciences.

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Real-time Elastography and Contrast-Enhanced Ultrasound for the Assessment of Thyroid Nodules

Abstract: RTE seems to be a useful tool in the work-up of thyroid nodules to exclude papillary thyroid cancer. However, follicular carcinoma remains a challenging problem. CEUS did not improve the characterization of thyroid nodules in this preliminary study.

Cited by 107 publications

References 15 publications

Utility and Interobserver Agreement of Ultrasound Elastography in the Detection of Malignant Thyroid Nodules in Clinical Care

Utility and Interobserver Agreement of Ultrasound Elastography in the Detection of Malignant Thyroid Nodules in Clinical Care

Evaluation of Strain Elastography for Differentiation of Thyroid Nodules: Results of a Prospective DEGUM Multicenter Study

Diagnostic Value of Contrast-Enhanced Ultrasound Evaluation of Malignant and Benign Solitary Thyroid Nodules

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