The diagnostic performance of shear wave speed (SWS) imaging for thyroid nodules with elasticity modulus and SWS measurement

Abstract

To evaluate the diagnostic performance of a new technique of shear wave speed (SWS) imaging for the diagnosis of thyroid nodule with elasticity modulus and SWS measurement. 322 thyroid nodules in 322 patients (216 benign nodules, 106 malignant nodules) were included in this study. All the nodules received conventional ultrasound (US) and SWS imaging (Aplio500, Toshiba Medical Systems, Japan) before fine-needle aspiration (FNA) and/or surgery. The values of E-max and E-mean with elastic modulus (61.27 ± 36.31 kPa and 31.89 ± 19.11 kPa) or SWS (4.45 ± 1.49 m/s and 3.26 ± 2.71 m/s) in malignant nodules were significantly higher than those in benign lesions (29.18 ± 18.62 kPa and 15.85 ± 6.96 kPa, or 2.98 ± 0.85 m/s and 2.19 ± 0.42 m/s, all P < 0.001). No significant differences in area under the curve (AUC) between the SWS imaging parameters were found (all P > 0.05). In multivariate logistic regression analysis, E-max (m/s) with SWS was identified to be the strongest independent predictor for malignant nodules (odds ratio [OR] = 16.760), followed by poorly-defined margin (OR = 7.792), taller-than-wide shape (OR = 3.160), micro-calcification (OR = 2.422), and E-max (kPa) with elastic modulus (OR = 0.914). The AUC was 0.813 for E-max with SWS (m/s) and 0.796 for E-max with elastic modulus (kPa). With cut-off SWS value of 3.52 m/s in E-max, sensitivity of 69.8%, specificity of 81.5%, and accuracy of 77.6% were achieved. SWS imaging is a valuable tool in predicting thyroid malignancy. E-max with SWS measurement is the strongest independent predictor for thyroid malignancy.

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

“…Emax had the best diagnostic performance, with a sensitivity, specificity, and AUC of 53.7%, 70.4%, and 0.633, respectively. In concordance with the present results, Wang et al [27] also reported, in a study of 322 thyroid nodules, that Emax was the only independently significant SWE imaging parameter, with a sensitivity of 59.40%, a specificity of 89.8%, and an AUC of 0.796 for differentiating between malignant and benign thyroid nodules. Several studies have reported a somewhat variable range of values of SWE imaging parameters that could be used to predict thyroid malignancies, especially regarding the optimal cutoff value of Emax.…”

Three‐Dimensional Shear Wave Elastography for Differentiating Benign From Malignant Thyroid Nodules

“…For 2D SWE, E_max was the best among the 4 SWE parameters in predicting thyroid malignancy, even though no significant differences were found among different SWE parameters, which was consistent with other studies using 2D SWE . Bhatia et al reported that compared with E_mean and E_SD, E_max had the best diagnostic performance in 2D SWE.…”

“…For 2D SWE, E_max was the best among the 4 SWE parameters in predicting thyroid malignancy, even though no significant differences were found among different SWE parameters, which was consistent with other studies using 2D SWE. 30,31 Bhatia et al 18 reported that compared with E_mean and E_SD, E_max had the best diagnostic performance in 2D SWE. He et al 31 found that the AUC of E_max was the highest among the 3 SWE parameters in 2D SWE (0.799), with the cutoff value (42.9 kPa), sensitivity (63.8%), specificity (88.2%), PPV (73.2%), and NPV (82.8%).…”

Shear Wave and Strain Elastographic Features of the Brachial Plexus in Healthy Adults: Reliability of the Findings—a Pilot Study

“…Based on the shear wave propagation speed differences of 2 or more points, the stiffness of the tissue is calculated by the Young modulus. The Young modulus ( E ) is related to tissue density ( ρ , ≈1000 kg/m 3 ) and the SWV ( V , meters per second), and it is calculated by the equation . The SWV is directly obtained by the differences between SWV values, whereas the elastic modulus is calculated by an equation.…”

“…The Young modulus (E) is related to tissue density (q, 1000 kg/m 3 ) and the SWV (V, meters per second), and it is calculated by the equation E53qV s 2 . 7,25,39 The SWV is directly obtained by the differences between SWV values, whereas the elastic modulus is calculated by an equation. Regarding the equation, the SWV value is more reliable than the elastic modulus, since tissue heterogeneity can affect the measurement.…”