Acoustic radiation force impulse imaging (ARFI) for differentiation of benign and malignant thyroid nodules—A meta-analysis

Zhan, Jia; Jin, Jia-Mei; Diao, Xinping; Chen, Yue

doi:10.1016/j.ejrad.2015.07.015

Cited by 66 publications

(37 citation statements)

References 29 publications

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“…In fact, related data also support this conclusion: the sensitivity and specificity of RTE for the diagnosis of malignant thyroid nodules were not steady: 79% and 77% [15], respectively to 92% and 90% [16]both results originate recent meta-analysis, while the sensitivity and specificity of ARFI were 0.86 and 0.90 [17] respectively to 0.80 and 0.85 [18]. Considering RTE was performed by different ultrasound device in different color-coded maps with different ES scales, this may be some of the reasons why there is considerable variation in the reported sensitivity and specificity of RTE.…”

Section: Discussionsupporting

confidence: 70%

“…And the stiffness overlaps between the benign and malignant thyroid nodules exits in ranged from 2.5 to 3 m/s. In recent meta-analysis, a total of 11 in 16 studies [18] reported the SWV cutoffs were ranged in 2.5-3 m/s which called "Grey Zone" of ARFI measurement. Therefore it is full of challenges to differential diagnosis the thyroid nodules in "Grey Zone" before the operation.…”

Section: Discussionmentioning

confidence: 99%

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Ultrasonographic United Stiffness Score System: Resolving the Discrepancy between Acoustic Radiation Force Impulse and Real-time Elastography in Evaluating the Thyroid Nodules Stiffness

Zhan¹,

Diao²,

Jin³

et al. 2017

Thyroid Disorders Ther

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Objective: The aim of this study was to assess the ultrasonographic united stiffness score system (UUSSS) in diagnosing thyroid nodules, and retrospectively analyze the discrepancy between acoustic radiation force impulse (ARFI) and real-time elastography (RTE).Methods:170 conventional ultrasound (US) proven thyroid nodules in 70 patients were included and all were examined by RTE and ARFI. RTE and ARFI were first analyzed respectively, comparing with pathological findings. Then nodules have discrepancy between ARFI and RTE were retrospectively analyzed by UUSSS. Results:The AUC (area under curve) of ARFI combined RTE in 170 nodules was 0.87 (sensitivity=79.4% (54/68), specificity=84.3% (86/102), PPV=77.1% (54/70), NPV=86.0% (86/100), accuracy for ARFI were 82.4% (140/170), relatively to RTE was 0.83, 80.9%, 65.7%, 61.1%, 83.8%, 71.8%.The AUC of UUSSS was 0.876 (sensitivity=83.8% (57/68), specificity=87.3% (89/102), PPV=81.4% (57/70), NPV=89.0% (89/100), accuracy for UUSSS was 85.9% (146/170). The difference between area under UUSSS and RTE ROC curves was statistically significant (p<0.05), but was insignificant between UUSSS and ARFI (p=0.2245). There were 47 thyroid nodules had discrepancy in assessing the stiffness between ARFI and RTE. In these nodules, the accuracy of UUSSS was 83.0% (39/47), there were significant difference compare to RTE (20/47) (p=0.000), and ARFI (27/47) (p=0.012). Conclusions:UUSSS is useful to increase the diagnostic accuracy compare to independent RTE and ARFI, especially for those had discrepancy between ARFI and RTE. UUSSS is easy and convenient to re-evaluate stiffness on RTE and ARFI basis, and it place no additional cost burden.

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Section: Discussionsupporting

confidence: 70%

Section: Discussionmentioning

confidence: 99%

Ultrasonographic United Stiffness Score System: Resolving the Discrepancy between Acoustic Radiation Force Impulse and Real-time Elastography in Evaluating the Thyroid Nodules Stiffness

Zhan¹,

Diao²,

Jin³

et al. 2017

Thyroid Disorders Ther

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“…A number of recent SWI meta-analyses have shown promising results 92-95, with similarities between the results owing at least in part to the significant overlap in the included studies. Zhan et al included pSWE studies and was the largest meta-analysis (2436 thyroid nodules); they found pSWE was useful for differentiating benign from malignant nodules (mean sensitivity = 80%, mean specificity = 85%, Table 3) 92. The meta-analysis by Dong et al also included pSWE studies and found similarly good results (1617 thyroid nodules, pooled sensitivity = 86.3%, pooled specificity = 89.5%, Table 3) 95.…”

Section: Clinical Applications Of Ultrasound Elastographymentioning

confidence: 99%

Ultrasound Elastography: Review of Techniques and Clinical Applications

et al. 2017

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Elastography-based imaging techniques have received substantial attention in recent years for non-invasive assessment of tissue mechanical properties. These techniques take advantage of changed soft tissue elasticity in various pathologies to yield qualitative and quantitative information that can be used for diagnostic purposes. Measurements are acquired in specialized imaging modes that can detect tissue stiffness in response to an applied mechanical force (compression or shear wave). Ultrasound-based methods are of particular interest due to its many inherent advantages, such as wide availability including at the bedside and relatively low cost. Several ultrasound elastography techniques using different excitation methods have been developed. In general, these can be classified into strain imaging methods that use internal or external compression stimuli, and shear wave imaging that use ultrasound-generated traveling shear wave stimuli. While ultrasound elastography has shown promising results for non-invasive assessment of liver fibrosis, new applications in breast, thyroid, prostate, kidney and lymph node imaging are emerging.Here, we review the basic principles, foundation physics, and limitations of ultrasound elastography and summarize its current clinical use and ongoing developments in various clinical applications.

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“…The target tissue is mechanically stimulated by short-duration acoustic pulses to produce small (1-10 mm) localized tissue displacements. The tissue displacement results in shear wave dissemination, which is tracked with a probe, and is measured as the SWV (in m/s) [16]. Previous data from different populations' tendons evaluated with ARFI showed that softer AT indicates tendinopathy [17][18][19].…”

Section: Introductionmentioning

confidence: 99%

Acoustic Radiation Force Impulse Elastography and Ultrasonographic Findings of Achilles Tendon in Patients With and Without Diabetic Peripheral Neuropathy: A Cross-Sectional Study

İyidir

Rahatli

Bozkuş

et al. 2019

Exp Clin Endocrinol Diabetes

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Aims We aimed to evaluate the elastographic features of Achilles tendon with Acoustic Radiation Force Impulse in patients with and without diabetic neuropathy. Methods According to the presence of peripheral neuropathy, 45 patients with type 2 diabetes were divided into 2 subgroups. Those with peripheral neuropathy were defined as group I (22 patients) and those without peripheral neuropathy were defined as group II (23 patients). A total of thirty age-, gender-, and body mass index-matched healthy individuals were selected as controls. All participants underwent both ultrasonographic and Acoustic Radiation Force Impulse elastographic examination in order to evaluate Achilles Tendon thickness and stiffness. Results Achilles tendon thicknesses were similar between groups (p=0.991). Achilles tendon thicknesses of both patient groups were significantly higher than the control group (group I vs control p=0.01; group II vs control p=0.006). Stiffness values of Achilles tendons were similar between the control group and group II (p=0.993). Shear Wave Velocity was significantly lower in group I than group IIand control group (p<0.001). Conclusion Diabetic patients with neuropathy have thicker and softer Achilles tendon while the elasticity of Achilles tendon in diabetic patients without neuropathy is similar to the healthy controls. Softening of the Achilles tendon may be an early sign of diabetic foot and reveal the patients with a risk of diabetic foot.

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Acoustic radiation force impulse imaging (ARFI) for differentiation of benign and malignant thyroid nodules—A meta-analysis

Cited by 66 publications

References 29 publications

Ultrasonographic United Stiffness Score System: Resolving the Discrepancy between Acoustic Radiation Force Impulse and Real-time Elastography in Evaluating the Thyroid Nodules Stiffness

Ultrasonographic United Stiffness Score System: Resolving the Discrepancy between Acoustic Radiation Force Impulse and Real-time Elastography in Evaluating the Thyroid Nodules Stiffness

Ultrasound Elastography: Review of Techniques and Clinical Applications

Acoustic Radiation Force Impulse Elastography and Ultrasonographic Findings of Achilles Tendon in Patients With and Without Diabetic Peripheral Neuropathy: A Cross-Sectional Study

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