Shear wave elastography and contrast-enhanced ultrasonography in the diagnosis of thyroid malignant nodules

Abstract

The aim of the present study was to evaluate the value of shear wave elastography (SWE) and contrast-enhanced ultrasonography (CEUS) in the diagnosis of thyroid malignant nodules. A total of 253 patients with 319 thyroid nodules were subjected to two-dimensional ultrasound (2DUS) and CEUS examinations prior to thyroidectomy between March, 2014 and December, 2015. Young's modulus value for each nodule on 2DUS and CEUS images were recorded. The sensitivity, specificity and accuracy of 2DUS, SWE and CEUS in the diagnosis of thyroid malignant nodules were assessed. The results demonstrated that, of the 319 nodules that were pathologically confirmed, 183 were malignant and 136 were benign. The area under the receiver operating characteristic curve as a result of SWE diagnosis was 0.77. When the threshold of the Young's modulus value was ≥27.65 kPa in the diagnosis of malignant thyroid nodules, SWE exhibited a sensitivity of 84.55% (115/136), a specificity of 84.15% (154/183) and an accuracy of 84.32% (269/319). US contrast imaging of malignant thyroid nodules revealed a major tendency for early hypoenhancement and hypoenhancement. CEUS exhibited a sensitivity of 87.5% (119/136), a specificity of 86.33% (158/183) and an accuracy of 86.83% (277/319) in the diagnosis of malignant thyroid nodules. Compared with 2DUS, SWE, CEUS and their combined use exhibited statistically significant differences in the diagnosis of thyroid malignant nodules in terms of sensitivity, specificity and accuracy (χ2=9.220,15.310 and 40.296, respectively; P=0.000); SWE or CEUS did not differ significantly in the diagnosis of thyroid malignant nodules in terms of sensitivity, specificity or accuracy (χ2=0.737;P=0.542); Compared with the use of SWE or CEUS alone, their combination exhibited statistically significant differences in the diagnosis of malignant thyroid nodules in terms of sensitivity, specificity and accuracy (χ2=12.264 and 6.939, respectively; P=0.000,0.005). In conclusion, the high accuracy of the combined use of SWE and CEUS in the diagnosis of malignant thyroid nodules is of great clinical value.

Diagnostic Performance of a Combination of Shear Wave Elastography and B-Mode Ultrasonography in Differentiating Benign From Malignant Thyroid Nodules

“…All elasticity parameters except Eratio (Emax, Emean, and Emin) on SWE were significantly higher for malignant thyroid nodules than for benign thyroid nodules. This observed relationship between elasticity and the likelihood of thyroid malignancy is consistent with several prior publications analyzing the use of SWE [11,[18][19][20][21]23].…”

“…Until now, the majority of US elastography studies for predicting thyroid malignancies have investigated strain elastography [15][16][17]. To the best of our knowledge, only a few studies have investigated the use of SWE to identify thyroid malignancies, and those studies showed varying results in terms of diagnostic performance and the optimal cutoff values of elasticity parameters [18][19][20][21]. Therefore, the aim of this study was to compare clinicopathologic and radiologic factors between benign and malignant thyroid nodules and to evaluate and verify the diagnostic performance of a combination of SWE and B-mode US in distinguishing histologically proven malignant from benign thyroid nodules.…”

Contrast‑enhanced ultrasonography features of papillary thyroid carcinoma for predicting cervical lymph node metastasis

“…Given that by providing visualization of the macro- and microvascularization of the tumor, contrast-enhanced US (CEUS) can evaluate thyroid tumors qualitatively and quantitatively. Though some studies have evaluated the value of CEUS in the diagnosis of thyroid malignant nodules ( 23 , 24 ), there are few studies available assessing CEUS to help risk-stratify PTC patients with LNM. In this study we investigated the clinical implications of CEUS in PTCs, and examined the relation between enhancements of PTC and the risk of LNM.…”

Value of Computer Software for Assisting Sonographers in the Diagnosis of Thyroid Imaging Reporting and Data System Grade 3 and 4 Thyroid Space‐Occupying Lesions

“…Ultrasound is the most commonly used imaging modality for thyroid space‐occupying lesions. The increase in the disease incidence has added to patients’ panic and has also increased the workload of sonographers . Computer‐aided systems for evaluating breast and lung cancer are considered effective auxiliary diagnostic tools that can improve the performance of imaging diagnosis by reducing the difference among sonographers and the rate of unnecessary false‐positive biopsy resuts .…”