Shear Wave Elastography: A New Ultrasound Imaging Mode for the Differential Diagnosis of Benign and Malignant Thyroid Nodules

Abstract

Promising results have been obtained with SWE. This technique may be applied to multinodular goiters. Larger prospective studies are needed to confirm these results and to define the respective places of SWE, US, and FNA.

Shear Wave Elastography Combining with Conventional Grey Scale Ultrasound Improves the Diagnostic Accuracy in Differentiating Benign and Malignant Thyroid Nodules

“…Liu et al [13] also reported that E mean ≥ 38.3 kPa was the most useful predictor among all SWE indices in differentiating benign and malignant thyroid nodule. In the present study, the optimal cut-off for E maximum and E mean for distinguishing benign and malignant nodules were 67.3 and 23.1 kPa, respectively, which were consistent with the result of previous reports in E maximum [15,36]. In our study, there was no significant difference in the E minimum of benign and malignant nodules, which was different from previous studies [13,33,34].…”

“…However, Bhatia et al [35] found that E mean of 34.5 kPa or higher was a significant predictor of malignancy with a sensitivity of 52.9% and specificity of 77.8%. Other studies suggested that SWE was useful in differentiating benign and malignant thyroid nodules when the cut-off level of 66 kPa and 65 kPa for E maximum were used, respectively [15,36]. However, Szczepanek-Parulska et al [37] found that the threshold value of 50 kPa for E maximum was the most useful SWE parameter in the differentiation of benign and malignant nodules.…”

“…However, potential sampling and analytical errors limit its application in establishing correct diagnosis in some cases such as small thyroid nodules [12,13]. Only about 65-75% of thyroid nodules can be correctly diagnosed by FNAC [14], whilst the remaining 25-35% of nodules yield indeterminate pathology or non-diagnostic results [15]. Both GSU and FNAC have wide ranges of sensitivity (52-97% and 54-90%, respectively), and specificity (26-83% and 60-98%, respectively) in distinguishing benign and malignant thyroid nodules [10,16].…”

The role of sonoelastography in acute, subacute and chronic thyroiditis: a novel application of the method

“…Recently, Park et al (24) demonstrated a high interobserver variability of the qualitative methods of elastographic evaluation, where the elasticity image and score depended on the extent of tissue compression. On the other hand, since the technique of Shear Wave Elastography used in our study is devoid of the need for freehand external compression, it can be assumed to be operator independent, reproducible, and objective in the evaluation of tissue firmness (25).…”

Thyroid Ultrasound: State of the Art. Part 2 – Focal Thyroid Lesions

“…Sebag et al investigated the efficiency of SWE in predicting malignancy in solitary or multiple thyroid nodules. Using a cut-off level of 65 kPa, they could predict malignancy with sensitivity of 85.2%, specificity of 93.9% and positive predictive value (PPV) of 92.3% [32].…”