Shear-Wave Elastography for the Preoperative Risk Stratification of Follicular-patterned Lesions of the Thyroid: Diagnostic Accuracy and Optimal Measurement Plane

Samir, Anthony E.; Dhyani, Manish; Anvari, Arash; Prescott, Jason D.; Halpern, Elkan F.; Faquin, William C.; Stephen, Antonia E.

doi:10.1148/radiol.2015141627

Cited by 113 publications

(90 citation statements)

References 62 publications

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“…The same idea was employed here to acquire SWE values from a larger nodule area without including parenchymal tissue. In terms of lower cutoffs compared to our results, the selection of study population might have a role; in a study by Samir et al (38), only thyroid nodules Bethesda categories III and IV were studied under SWE with a final cutoff value of 22.3 kPa. By comparing our cutoff result of 48.40 kPa with the mean values of Bethesda groups III and IV in Table 1 it can be observed that all values are below the threshold, thus, we hypothesize that including other Bethesda groups in the statistical analysis may lower the cutoff values.…”

Section: Discussionmentioning

confidence: 76%

Differentiation of Benign and Malignant Thyroid Nodules by Using Comb-push Ultrasound Shear Elastography

et al. 2018

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Rationale and Objectives Low specificity of traditional ultrasound in differentiating benign from malignant thyroid nodules leads to a great number of unnecessary (i.e. benign) fine needle aspiration biopsies that causes a significant financial and physical burden to the patients. Ultrasound shear wave elastography is a technology capable of providing additional information related to the stiffness of tissues. In this study, quantitative stiffness values acquired by ultrasound shear wave elastography in two different imaging planes were evaluated for the prediction of malignancy in thyroid nodules. In addition, the association of elasticity measurements with sonographic characteristics of thyroid gland and nodules is presented. Materials and Methods A total number of 155 patients (106 female and 49 male) (average age 57.48±14.44 years) with 173 thyroid nodules (average size 24.89±15.41mm, range 5–68mm) scheduled for fine needle aspiration biopsy were recruited from March 2015 to May 2017. Comb-push shear elastography imaging was performed at longitudinal and transverse anatomical planes. Mean (Emean) and maximum (Emax) elasticity values were obtained. Results Measurements at longitudinal view were statistically significantly higher than measurements at transverse view. Nodules with calcifications were associated with increased elasticity and nodules with a vascular component or within an enlarged thyroid gland (goiter) were associated with a lower elasticity value. Receiver operating characteristic curve analysis was performed for Emean and Emax at each imaging plane and for the average of both planes. 95.45% sensitivity, 86.61% specificity, 0.58 PPV, and 0.99 NPV were achieved by the average of the two planes for each Emean and Emax parameters, with area under the curve of 92% and 93%, and a cutoff value of 49.09 kPa and 105.61 kPa, respectively. Conclusions The elastic properties of thyroid nodules showed promise to be a good discriminator between malignant and benign nodules (p<0.0001). However, probe orientation and internal features such as calcifications, vascular component and goiter may influence the final elastography measurements. A larger number of malignant nodules need to be studied to further validate our results.

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Section: Discussionmentioning

confidence: 76%

Differentiation of Benign and Malignant Thyroid Nodules by Using Comb-push Ultrasound Shear Elastography

et al. 2018

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“…Perhaps a larger study is needed to evaluate the ability of SWV in TC-subtype differentiation. In a recent Radiology publication, Samir et al (2015) also demonstrates the potential benefit of SWV in TNs with atypical FNAB (BC III or BC IV) in a pilot study of 35 patients.…”

Section: Potential Future Use Of Vtiqmentioning

confidence: 97%

Thyroid Nodules and Shear Wave Elastography: A New Tool in Thyroid Cancer Detection

Azizi

Keller²,

Mayo

et al. 2015

Ultrasound in Medicine & Biology

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This study determines the performance of virtual touch imaging quantification (VTIQ), a non-invasive shear wave elastography method for measuring thyroid nodule (TN) stiffness, in distinguishing benign from malignant TNs. This prospective study evaluates 707 TNs in 676 patients with fine-needle aspiration biopsy (FNAB). Before FNAB, both conventional B-mode ultrasound and shear wave elastography were performed. Surgical resection was recommended for FNAB results that were not clearly benign. Surgical pathology confirmed 82 malignant TNs. The receiver operating curve identified a single cut-off of 3.54 m/s as the maximum shear wave velocity (SWV) for predicting thyroid cancer (TC). The sensitivity and specificity were 79.27% and 71.52%, respectively. Positive predictive value (PPV) was 26.75% and negative predictive value (NPV) was 96.34%. Compared with B-mode US features for predicting malignancy, SWV ≥3.54 m/s has a higher sensitivity, specificity, PPV and NPV. TN stiffness measured by VTIQ-generated shear wave elastography is an independent predictor of TC.

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“…Sonoelastography (SE) is a new imaging technique that measures the mechanical properties of tissue [14], and has seen early adoption as a non-invasive substitute for liver fibrosis staging [15][16][17][18][19][20][21], characterization of thyroid nodules [22][23][24], and localization of prostate cancer [24,25]. In this case report, we review a case of amyloidosis of the liver with findings seen on ultrasound shear wave elastography and also review the literature on the topic.…”

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confidence: 99%

Amyloidosis of the liver on shear wave elastography: case report and review of literature

et al. 2015

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Amyloidosis is extremely rare, with an estimated 2225 new US cases reported annually. Signs and symptoms of the disease are subtle and imaging findings are not pathognomonic. Currently, diagnosis requires biopsy to demonstrate the deposition of amyloid. Elastography is a new imaging modality that evaluates tissue elasticity. It has shown to have efficacy in characterizing thyroid nodules, detecting prostate cancer, and staging liver fibrosis. We present a case of hepatic amyloidosis in a 51-year-old male that demonstrates significantly increased stiffness with a median value of 99.1 kPa (range 25.7-188.9 kPa) on shear-wave elastography (SWE) imaging, which is significantly higher than the cut-off range reported for cirrhosis on SWE (10.4-11.5 kPa). This finding raises the possibility that elastographic imaging may be sensitive to tissue mechanical changes induced by amyloid deposition.

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Shear-Wave Elastography for the Preoperative Risk Stratification of Follicular-patterned Lesions of the Thyroid: Diagnostic Accuracy and Optimal Measurement Plane

Abstract: This prospective pilot study indicates that SWE may be a valuable tool in preoperative malignancy risk assessment of follicular-patterned thyroid nodules.

Cited by 113 publications

References 62 publications

Differentiation of Benign and Malignant Thyroid Nodules by Using Comb-push Ultrasound Shear Elastography

Differentiation of Benign and Malignant Thyroid Nodules by Using Comb-push Ultrasound Shear Elastography

Thyroid Nodules and Shear Wave Elastography: A New Tool in Thyroid Cancer Detection

Amyloidosis of the liver on shear wave elastography: case report and review of literature

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