Elastography in the Differential Diagnosis of Thyroid Nodules (original) (raw)
Related papers
Role of Elastography in Ultrasound Evaluation of Thyroid Nodules
2017
Background: Ultrasound is the modality of choice for evaluation of thyroid nodules. Elastography plays a complimentary role in characterizing the thyroid nodules. Objectives: This study is undertaken to evaluate the role of Elastography in evaluation and characterization of the thyroid nodules. Materials and methods: Fifty cases of thyroid nodules who underwent ultrasound evaluation during March 2016 to march 2017 were included in the study. Elastography was performed during the same sitting. Ultrasound guided FNAC was performed for cytological correlation. Results: Out of the 50 patients 80% were females and 20% were males. Forty two cases were benign on FNAC and 35 of these were seen in females. Eight cases were malignant nodules. Out of the eight cases which were diagnosed as malignant, marked hypo-echogenicity, micro-calcification, intrinsic vascularity and elastography features were found to be useful in differentiating benign from malignant lesions. The sensitivity and specifi...
The efficiency of US elastography in the differential diagnosis of thyroid nodules
Journal of the Belgian Society of Radiology, 2015
To evaluate the efficiency of ultrasound elastography (Use) in the differential diagnosis of thyroid nodules. Methods: one hundred thyroid nodules in 100 patients (79 females, 21 males, age range 18-78; mean age = 45.6 years) were evaluated with real-time freehand Use, using hitachi eUB 7500 equipment and elasticity scores were obtained. The elasticity was scored as follows: score 1, elasticity in the entire nodule; score 2, mainly elastic nodule with the presence of inelastic areas not constant during real time examination; score 3, constant inelastic areas prevalently arranged at the periphery of the nodule; score 4, constant inelastic areas prevalently arranged at the center of the nodule; score 5, no elasticity in the nodule. also mean strain ratio values were calculated for all nodules. Results: eighty-four (86%) of cases were benign and sixteen (16%) were malignant. elasticity score 3 and higher and strain ratio higher than 2.485 had statistically significant relation with malignancy (p < 0.05). Conclusions: Use including strain ratio calculations besides subjective evaluation of elasticity scores is an efficient imaging method which may contribute to the differential diagnosis of thyroid nodules.
La Radiologia medica, 2013
Purpose This study was done to compare quantitative elastosonography and ultrasound analysis in the characterisation of thyroid nodules. Materials and methods From July 2009 to September 2011, 123 patients with 147 thyroid nodules were included in our study. All patients enrolled had to undergo thyroidectomy because of nodular thyroid disease (goitre or nodules). After preliminary examination with conventional ultrasound (US) and colour Doppler US, the patients were examined with elastosonography, using high-level equipment (Toshiba Aplio XG) and quantitative software (Elasto-Q). Each lesion was characterised using an US score (echogenicity, borders, microcalcifications and colour Doppler pattern), and then by elastosonographic strain ratio. Each patient subsequently underwent thyroidectomy. Histological results were used as the gold standard. Results Histological examination demonstrated 89 benign and 58 malignant lesions. On average, the strain ratio value was 2.84±2.69 (range, 0.05–14.5; p=0.001). Sensitivity and specificity of the US score were about 56% and 72%, respectively, whereas those of the strain ratio were 93% and 89%, using a cut-off of 2 obtained with receiver operating characteristic (ROC) curve analysis. Elastosonography was more accurate than US and colour Doppler US in characterising thyroid nodules (p=0.002). Conclusions Quantitative elastosonography is a useful diagnostic tool in the evaluation of thyroid lesions, and can be used to limit fine-needle aspiration cytology and improve the selection of patients for thyroidectomy. Obiettivo Scopo del presente lavoro è stato confrontare elastosonografia quantitativa ed analisi ecografica nella caratterizzazione del nodulo tiroideo. Materiali e metodi Tra luglio 2009 e settembre 2011 sono stati arruolati 123 pazienti con 147 noduli candidati all’intervento di tiroidectomia totale per la presenza di patologia nodulare tiroidea. Dopo valutazione preliminare con ecografia e color Doppler, i pazienti sono stati sottoposti ad elastosonografia, mediante software quantitativo Elasto-Q con apparecchiatura Toshiba Aplio XG. Ogni nodulo è stato caratterizzato mediante ecoscore (ecogenicità, margini, microcalcificazioni, pattern color Doppler) e indice di deformabilità (strain ratio). I risultati istologici sono stati utilizzati come gold standard. Risultati I noduli esaminati sono risultati benigni in 89 casi e maligni in 58. Alla valutazione elastosonografica la media dei valori di strain ratio è stata 2,84±2,69 (p=0,001). Si sono ottenuti valori di sensibilità e specificità rispettivamente 56% e 72% per l’eco-score e 93% e 89% per lo strain ratio, utilizzando un cut-off pari a 2, con un valore predittivo positivo del 55% e dell’82% rispettivamente. La tecnica elastosonografica ha mostrato maggiore accuratezza dell’ecografia e del color Doppler nella caratterizzazione delle lesioni tiroidee (p=0,002). Conclusioni L’elastosonografia quantitativa è uno strumento valido per la caratterizzazione dei noduli tiroidei, utile per ridurre il ricorso all’agoaspirato, in particolare nei casi incerti.
Pakistan Journal of Medical and Health Sciences, 2022
Background: Elastography is a method recently being used in the evaluation of thyroid nodules by comparing tissue elasticity. The aim of this study was to determine the diagnostic accuracy of elastography in differentiation between benign and malignant thyroid nodules, taking histopathology as gold standard. Methods: Total of 50 patients with palpable thyroid nodule of any size of age 20-60 years of either gender were included. elastography was performed in every patient by using a high resolution unit with a linear array probe centered at 7.5 MHz, elastography was performed in every patient by a consultant radiologist benign or malignant thyroid nodules was noted. Elastography findings were compared with histopathology report Results: All the patients were subjected to strain ultrasound elastography. USG supported the diagnosis of malignant thyroid nodules in all 50 patients. Histopathology confirmed malignant thyroid nodules in 46 (true positive) cases where as 4 (false positive) had no malignant lesion on histopathology. In USG negative patients, 47 were true negative while 2 were false negative. Overall sensitivity, specificity, positive predictive value, negative predictive value and diagnostic accuracy of strain ultrasound elastography in differentiation between benign and malignant thyroid nodules, taking histopathology as gold standard is 90.0%, 90.30%, 92.31%, 94.77% and 93.18% respectively Conclusion: According to this study, strain ultrasound elastography is the non-invasive modality of choice with high diagnostic accuracy in diagnosing malignant thyroid nodules.
Turkish Journal of Surgery, 2014
Objective: We aimed to evaluate the predictive value of elastography in determining malignancy during preoperative investigation of thyroid nodules and to compare its results with preoperative fine-needle aspiration biopsy (FNA) and postoperative histopathology results. Material and Methods: Among the group of patients who had indications for thyroidectomy between January 2013-September 2013 in the department of general surgery 86 euthyroid patients were prospectively included in the study. Informed consent was obtained from all patients. All patients received simultaneous thyroid ultrasonography and elastography by an experienced radiologist. The patients were classified into five scores according to Tsukuba scoring. Score 1 and 2 were evaluated as soft nodules (benign), score 3 as medium consistency (usually benign), and scores 4 and 5 as hard nodules (malignant). For statistical purposes, the FNA results were classified as benign, probably benign or malignant. The histopathological results were classified as benign or malignant. The results were compared with FNA and elastography findings. Results: The fine-needle aspiration biopsy of the nodules revealed 60.5% benign, 17.4% high probability of benign, and 22.1% malignant cases; and the elastography diagnosed 38.4% benign, 23.3% high probability of benign, and 38.4% malignant nodules. The postoperative pathology evaluation diagnosed 67.4% of patients as benign, and 32.6% as malignant. The rate of detection of thyroid cancer cases (sensitivity) by elastography was 67.9%, the ability to distinguish healthy individuals (specificity) was 75.9%, and the overall adequacy of the method (accuracy) was determined as 73.3%. Conclusion: Elastography overlaps with especially benign cytology-pathology at a high rate, and provides definite diagnosis in 58% of malignant cases. In our study, elastography provided more reliable results than FNA, in terms of diagnosing malignancy.
Elastography : Novel Development in Ultrasound for the Differential Diagnosis of Thyroid Nodules
Al-Azhar Medical Journal, 2013
Our aim was to compare the effectiveness of conventional ultrasonography and ultrasound elasto-graphy in differential diagnosis of thyroid nodular diseases, using Accuvix V20. The examination results were compared against pathological findings obtained by fine-needle aspiration biopsy. Clear high-quality elastograms were obtained and proved useful in the characterization of thyroid nodules, greatly improving the diagnostic rate of thyroid nodular diseases. Thus, elastograhy can be a useful adjunct tool for traditional ultrasound diagnosis.
Elastography as predictor for thyroid nodule malignancy
World Family Medicine Journal /Middle East Journal of Family Medicine
Background: Ultrasound elastography is a promising noninvasive technique that is still in its infancy. It uses tissue elasticity measurements to distinguish between benign (soft tissues) and malignant (hard tissues) nodules. Objectives: to see if elastography has diagnostic significance and if it may be used as a predictor of thyroid nodule malignancy Methods: An analytical cross-sectional study was done and data collected using Philips Epiq 7 linear transducer 8-12MHZ, strain type of elastography. A sample of 27 patients from Al-Hada Armed Forces Hospital, Taif, Saudi Arabia were included. Data about patients’ demographics, AP, TR, Echogenicity, Margin, Composition, Echogenic foci, FNA result, Elastography findings and TIRADs classification were collected. Results: According to FINA findings, the majority of patients (96.3 percent) had a benign tumour, and 81.5 percent had soft elastography. T2 was the most common TIRADs classification (55.6 percent). The percentage of patients wit...
2017
BACKGROUND: Ultrasound elastography is a noninvasive technique for evaluating thyroid nodules that encompasses a variety of approaches such as supersonic shear imaging and acoustic radiation force impulse imaging as well as real-time tissue elastography. This technique is very useful in differentiating malignant thyroid nodules from benign ones. OBJECTIVE: To determine the diagnostic accuracy of ultrasound elastography in differentiating benign from malignant thyroid nodules by using FNAC as a reference standard METHODOLOGY: 165 patients were selected for this study. The ultrasound examination including grey scale, doppler as well as elastography of thyroid nodules. Then ultrasound guided FNAC of selected nodule was performed and its result was obtained in order to compare diagnosis of ultrasound elastography and cytolology as operational definition. RESULTS: In our study, 42.42%(n=70) were males and 57.58%(n=95) were females,61.82%(n=102) were between 18-40 years of age while 38.1...
https://www.ijhsr.org/IJHSR\_Vol.7\_Issue.6\_June2017/IJHSR\_Abstract.06.html, 2017
Our study aimed to compare between ultrasound elastography (UE) and fine needle aspiration cytology (FNAC) in prediction of malignancy in thyroid nodules based on histopathology results. A total of 60 patients with thyroid nodules, who had an indication of thyroidectomy, were involved in this study after approval was obtained. They were selected for ultrasound elastography (UE) and fine needle aspiration before surgery. Then followed by FNA, and further with histopathology after surgery. 19 cases in elastography examination which diagnosed as benign nodules and confirmed histologically were classified as score 1and 2. The sensitivity of the elastography was 87.5% and specificity 85.7% whereas FNA showed 87.5 %, and % 96.4 for sensitivity, specificity respectively. ROC analysis showed the area under the elastography curve was 0.88 (95% confidence interval, 0.712 to 1.02) while 0.92 (95% confidence interval, 0.779 to 1.06) for FNA curve. FNA is still more reliable than ultrasound elastography, but UE is an easy, non-invasive and fast imaging technique that can help in thyroid scans to identify cases for FNA, reducing the number of unnecessary biopsies, and thus reducing risks and costs. However, future developments are needed for this promising diagnostic technique.
The Journal of Clinical Endocrinology & Metabolism, 2013
Context: Ultrasound (US) elastography (USE) was recently been reported as a sensitive, noninvasive tool for identifying thyroid cancer. However, the accuracy of this technique is hampered by the intra-and interoperator variability, some US features of the nodule, and the coexistence of autoimmune thyroid disease (ATD). Objectives: The purpose of this article was to assess the accuracy of USE findings in the differential diagnosis of thyroid nodules compared with other US features to evaluate its feasibility in the presence of ATDs and identify the strain index (SI) cutoff with the highest diagnostic performance. Design: We evaluated 528 consecutive patients for a total of 661 thyroid nodules. All nodules underwent fine-needle aspiration cytology (FNAC) and USE evaluation. The SI was calculated as a ratio of the nodule strain divided by the strain of the softest part of the surrounding normal tissue. Results: The median SI value was significantly higher in THY4 and THY5 than in THY2 nodules in ATD-positive, ATD-negative, and ATD-unknown patients. The cutoff of SI for malignancy was estimated to be 2.905 by receiver operating characteristic curve analysis in a screening set (379 FNAC results), and then tested in a replication set (252 FNAC results). In all cases, a SI value of Ն2.905 conferred to the nodule a significantly greater probability of being malignant. This SI cutoff had the greatest area under the curve, sensitivity, and negative predictive value, compared with the conventional US features of malignancy. Conclusion: The elastographic SI has a high sensitivity, specificity, and negative predictive value for the diagnosis of thyroid malignancy both in the presence and in the absence of ATD. If our data on USE are also confirmed in THY3 nodules, FNAC could be avoided in a number of thyroid nodules with certain features.