Does Shear Wave Elastography Provide Additional Value in the Evaluation of Thyroid Nodules That Are Suspicious for Malignancy?

Abstract

The SWE elasticity indices of malignant thyroid nodules were significantly high. Adding SWE to conventional US did not improve diagnostic performance.

The values of shear wave elastography in avoiding repeat fine‐needle aspiration for thyroid nodules with nondiagnostic and undetermined cytology

“…Conversely, Kim et al showed that an E SD of 6.5 kPa was the most accurate threshold, giving a relatively low sensitivity of 50.0% but a high specificity of 96.6%. Wang et al showed that US yielded the highest sensitivity and lowest specificity for malignancy when grey‐scale US was combined with an E SD cut‐off value of 6.8 kPa for thyroid nodules. These inconsistent results are likely due to analysis in a heterogeneous group of patients with thyroid cancers, including follicular, anaplastic and medullary cancer, and/or lymphoma.…”

Role of Strain Elastography and Shear-Wave Elastography in a Multiparametric Clinical Approach to Indeterminate Cytology Thyroid Nodules

“…We particularly focused on the use of elastography, as several studies have found that low elasticity of the lesion is related with a higher incidence of malignancy [ 32 – 34 ], though it is also related with other histological features, such as the presence of fibrosis and the expression of galectin-3 and fibronectin-1 [ 33 ]. Although elastography can be performed in various ways and by means of various techniques [ 25 ], there is no consensus as to which approach is most able to rule out malignancy.…”

Comment on “Adding Shear Wave Elastography to Conventional Sonography Did Not Improve Diagnostic Performance: Was There a Problem With the Cutoff Value?”

“…In fact, the American Associations of Clinical Endocrinologist's latest guidelines accept a cutoff value as 3.1 m/s . However, in the study by Wang et al, this cutoff value was 40.7 kPa, which corresponds to 3.6 to 3.7 m/s. We emphasize that the results in this study were due to the very high cellular and/or rigid content of the examined nodules, which causes the aforementioned SWV increase and may have already been altered enough to be detected as malignant on conventional B‐mode ultrasonography.…”

“…To the Editor : We have carefully read the valuable work of Wang et al titled “Does Shear Wave Elastography Provide Additional Value in the Evaluation of Thyroid Nodules That Are Suspicious for Malignancy?” We effectively use shear wave elastography (SWE) in superficial organs for our academic training and in our daily practice. We wanted to share our own experiences on this subject, since Wang et al concluded that “Adding SWE to conventional ultrasonography did not improve diagnostic performance” in their study. With all our respect, we believe that SWE is a promising radiologic modality, which has been continuously developing over the last decades, and the use of SWE by radiologists should not be discouraged by this conclusion.…”