Differentiation of benign from malignant thyroid nodules with acoustic radiation force impulse technique

Abstract

Objective: The aim of our study was to assess the performance of acoustic radiation force impulse (ARFI) imaging to differentiate benign from malignant thyroid nodules. Methods: 182 patients who needed thyroid surgery were examined. All patients and 50 healthy volunteers underwent ARFI sonoelastography, which quantitatively analysed the elasticity and hardness of the nodule's centre and periphery.Results: ARFI values showed a statistical significance between malignant nodules and benign nodules and common thyroid parenchyma, in both the centre and periphery of nodules (p , 0.01). There was no significant difference between benign nodules and common thyroid parenchyma in either the nodule's centre or periphery (p . 0.05). There was no significant difference between the nodule's centre and periphery of the elastic parameters in both the benign and malignant nodules. There was a statistically significant difference among the two areas (the central group and the peripheral group) under the receiver operating characteristic curve, and the optimal model was the peripheral group. For differentiation of malignant from benign nodules, the sensitivity and specificity were 96.3% and 96.2%, respectively, when 2.545 m s 21 was chosen as a cut-off value in the peripheral group. Conclusion: ARFI imaging may be helpful to differentiate benign nodules from malignant thyroid nodules. The selecting measurement position is important in ARFI imaging, and it has good diagnostic value in clinical applications. Advances in knowledge: This study shows the diagnostic contribution of ARFI imaging in thyroid lesions.Thyroid cancer is the most common endocrine malignancy, and its incidence has increased in recent years. 1 It comprises different clinical and histological features in respect to different treatments. 2 The diagnostic method for thyroid cancer has very quickly progressed in recent years, but the pre-operative misdiagnosis rate is 40-70%.A newer ultrasound elastography technique called acoustic radiation force impulse (ARFI), which is performed under direct visual guidance, has recently been verified to measure the stiffness of many tissues in vivo, for example in the liver. 3,4 In our study, we investigated the mechanical properties of focal thyroid disease with ARFI. The purposes of this study were to assess the effectiveness of ARFI quantification in the diagnosis of focal thyroid nodules and differentiation of benign from malignant thyroid lesions by quantification of their stiffness. METHODS AND MATERIALS PatientsOur study was approved by the ethics review board of our institution. Patients provided signed informed consent.Between August 2009 and February 2011, 182 patients (88 male patients and 94 female patients) with thyroid nodules referred to the Qilu Hospital of Shandong University, Jinan, China, were enrolled in our study. A detailed medical history was obtained from all patients. Mean age of the patients was 53.67 years (range, 27-83 years). Mean diameter of the nodules was 3.97 cm (range, 3.0-5.5 cm). There were 69...

Comparing the Diagnostic Accuracy of RTE and SWE in Differentiating Malignant Thyroid Nodules from Benign Ones: a Meta-Analysis

“…The reason for this results is that our study included 20 published articles about SWE, while there only 5 included studies in the article of Zhang et al [13] and 15 in the article of Lin et al [86]. Then, contrasting with these included studies, our study not only contained the case control studies which have high sensitivity and specificity, like Zhuo et al [78] and Sebag et al [10] (SEN = 0.963, SPE = 0.962; SEN = 0.852, SPE = 0.939), but also incorporated those with poor results, like Xu et al [73] and Szczepanek-Parulska et al [63] (SEN = 0.682, SPE = 0.769; SEN = 0.761, SPE = 0.641). Hence, SWE have a slight lower, but a more robust result based on our abundant included studies.…”

Acoustic Radiation Force Impulse imaging for detecting thyroid nodules: a systematic review and pooled meta-analysis.

“…All the quality assessment items of the included studies had a low risk of bias except for one study [38] did not describe the reason for the excluded patients.…”

“…Six papers were further excluded because the authors analyzed the SWE but not SWV. Therefore, 13 studies [26][27][28][29][30][31][32][33][34][35][36][37][38] were ultimately included in the meta-analysis. Figure 1 lists the diagram of the study selection process.…”

Quantitative Shear Wave Velocity Measurement on Acoustic Radiation Force Impulse Elastography for Differential Diagnosis between Benign and Malignant Thyroid Nodules: A Meta-analysis

“…(v) Only original complete publications (no editorials letters, abstracts or reviews) were included in the analysis, and complete reported data (sensitivity, specificity) were necessary to calculate the true positive (TP), false positive (FP), false negative (FN) and true negative (TN) cases. The studies were excluded for one of three reasons (i) In the presence of incomplete data (n 5 2) Zhuo et al 2014), the corresponding author was contacted and required to provide the missing data via E-mail; the study would be excluded if the author did not reply. (ii) Diffuse thyroid diseases other than thyroid nodules were included in the study (n 5 1) (Sporea et al 2012).…”