High Diagnostic Accuracy and Interobserver Reliability of Real-Time Elastography in the Evaluation of Thyroid Nodules

Ragazzoni, Federico; Deandrea, Maurilio; Mormile, Alberto; Ramunni, M; Garino, Francesca; Magliona, Gabriella; Motta, Manuela; Torchio, Bruno; Garberoglio, R; Limone, Paolo Piero

doi:10.1016/j.ultrasmedbio.2012.02.025

Cited by 88 publications

(81 citation statements)

References 38 publications

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“…Moderate interobserver agreement was also noted using the reverse color Asteria score [60]. However, later studies using the four score scale reported little interobserver variability [46], with almost perfect interobserver agreement [17], better for RTE than for the TIRADS score [6]. Excellent interobserver agreement was also reported using a three score gray scale system [55].…”

Section: Figmentioning

confidence: 89%

Ultrasound elastography in thyroid disease

Dudea

Botar-Jid

2015

Med Ultrason

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Thyroid elastography has become, lately, one of the main focuses in thyroid imaging. With more than one hundred papers published on this subject, the core of accumulated knowledge justifies the need for a comprehensive review on the topic. The paper presents the various elastographic techniques used for thyroid assessment. Both strain and shear wave elastography, with all their variants, are discussed. Thereafter the paper proceeds to a detailed description of the technical peculiarities, diagnostic value, limitations and pitfalls for each technique. Although the main accent is placed on thyroid nodules, the applications of elastography in other thyroid disease, diffuse or focal, are also presented. The results of the available metaanalyses are reviewed and the proven value of the technique is highlighted. Still unanswered questions and directions for future research are emphasized, whenever appropriate.

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Section: Figmentioning

confidence: 89%

Ultrasound elastography in thyroid disease

Dudea

Botar-Jid

2015

Med Ultrason

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“…Hence, for particular configurations (such as arteries), this shear wavelength becomes larger than local strong heterogeneities, leading to guided mode propagation. Recent studies have reported the potential clinical value of shear wave elastography in the diagnosis of malignancy in a range of applications, including the breasts [14], liver [15], thyroid [16], prostate [17], cervical lymph node [18], and salivary glands [19], though very few studies have considered vascular applications [20][21]. Ramnarine et al findings indicated that SWE can quantify Young's modulus of carotid plaque phantoms with good reproducibility [20][21] and could help establish the potential clinical value of the additional elasticity information for the identification of unstable carotid plaque and risk of stroke.…”

Section: Discussionmentioning

confidence: 99%

Assessment of the arterial stiffness in patients with acute ischemic stroke using longitudinal elasticity modulus measurements obtained with Shear Wave Elastography.

Wang

et al. 2016

Med Ultrason

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Aim: Arterial wall elasticity including the circumferential and longitudinal modulus is a measure of sub-clinical cardiovascular disease; the circumferential modulus is increased in acute ischemic stroke (AIS). There are still no reports of non-invasive measurement of longitudinal elastic modulus of arterial wall and its prospect of clinical application. In this study, the longitudinal elastic modulus of the arterial wall was assessed using real-time shear wave elastography in patients with AIS. The technique's feasibility and its related factors were studied initially. Materials and methods: In this study 179 patients with AIS and 168 ageand sex-matched controls were examined. The pulse wave velocity (PWV) of the bilateral carotid arteries was measured using radio frequency ultrasound technology. The 20 areas of superficial walls of bilateral carotid artery were analyzed by real-time shear wave elastography (SWE), and the average values of longitudinal average elastic modulus (ME mean ), maximum elastic modulus (ME max ), minimum elastic modulus (ME min ), and elastic modulus standard deviation (ME SD ) were measured. Results: The PWV, ME mean , ME max and ME SD of the carotid artery in patients with AIS were greater than those in the control group. Age, systolic blood pressure, PWV, and low-density lipoprotein were positively related to ME mean and ME max (r=0.221and r=0. 248, r=0.174 and r=0.176, r=0.776 and r=0.716, r=0.173 and r=0.200, p<0.05) and were independent risk factors for ME mean and ME max . ROC curves for detection of ischemic stroke as decided by PWV, ME mean and ME max . The area under the curves were 0.55±0.03 (p≤0.05), 0.59±0.03 (p≤0.05) and 0.60±0.03 (p=0.023), respectively. The optimal PWV, ME mean and ME max cutoff values for the detection of ischemic stroke were 9.66 m/s, 55.4 kPa and 65.4 kPa, with 69%, 73% and 73% sensitivity and 89%, 53% and 51% specificity, respectively. Conclusions: SWE could measure non-invasively the longitudinal elastic modulus of the arterial wall and evaluate the arterial stiffness. It was equivalent to the PWV which showed circular elastic modulus of arterial wall on evaluating AIS. Age, systolic blood pressure, pulse wave velocity, and low-density lipoprotein were independent risk factors for longitudinal elastic modulus. SWE may be effective in the assessment of arterial stiffness and offer a potential clinical benefit.

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“…However, with the development of elastographic methods (for examples the ones used for the assessment of thyroid nodules), interobserver variability proved to no longer be a drawback. Furthermore, the association of US examination with elastography has proven extremely useful for a better characterization of thyroid nodules [46][47][48]. Regarding endorectal elastography, there are still not enough studies to make firm statements.…”

Section: Gray Scale Us (2d 3d)mentioning

confidence: 99%

Endoscopic ultrasound for the characterization and staging of rectal cancer. Current state of the method. Technological advances and perspectives.

et al. 2015

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Endoscopic ultrasound is the most accurate type of examination for the assessment of rectal tumors. Over the years, the method has advanced from gray-scale examination to intravenous contrast media administration and to different types of elastography. The multimodal approach of tumors (transrectal, transvaginal) is adapted to each case. 3D ultrasound is useful for spatial representation and precise measurement of tumor formations, using CT/MR image reconstruction; color elastography is useful for tumor characterization and staging; endoscopic ultrasound using intravenous contrast agents can help study the amount of contrast agent targeted at the level of the tumor formations and contrast wash-in/wash-out time, based on the curves displayed on the device. The transvaginal approach often allows better visualization of the tumor than the transrectal approach. Performing the procedure with the rectal ampulla distended with contrast agent may be seen as an optimization of the examination methodology. All these aspects are additional methods for gray-scale endoscopic ultrasound, capable of increasing diagnostic accuracy. This paper aims at reviewing the progress of transrectal and transvaginal ultrasound, generically called endoscopic ultrasound, for rectal tumor diagnosis and staging, with emphasis on the current state of the method and its development trends.

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High Diagnostic Accuracy and Interobserver Reliability of Real-Time Elastography in the Evaluation of Thyroid Nodules

Cited by 88 publications

References 38 publications

Ultrasound elastography in thyroid disease

Ultrasound elastography in thyroid disease

Assessment of the arterial stiffness in patients with acute ischemic stroke using longitudinal elasticity modulus measurements obtained with Shear Wave Elastography.

Endoscopic ultrasound for the characterization and staging of rectal cancer. Current state of the method. Technological advances and perspectives.

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