Role of ultrasound elastography in assessment of indeterminate thyroid nodules

Habib, Lobna Abdel Monem; Abdrabou, Ahmed M.; Geneidi, Eman Ahmed Shawky; Sultan, Yousra M.

doi:10.1016/j.ejrnm.2015.11.002

Cited by 9 publications

(8 citation statements)

References 24 publications

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“…However, there were 13/26 false positives among those that scored 4b or 5 in TI-RADS system, results that are in line with those of Xue et al [39]. The negative predictive value of both elastography (82.3%) and TI-RADS model (86.6%) increases the confidence of recommending active follow up in intermediate cytology cases with low risk ultrasound and elastography appearance, as described in other studies [19,20]. As Doppler information is currently not used in the standard TI-RADS [18] we did not use them in our analysis.…”

Section: Discussionsupporting

confidence: 86%

“…However, the role of elastography in the management of nodules with indeterminate cytology is still debated since the results of the studies are contradictory. There are many positive studies, showing that increased stiffness is associated with thyroid cancer, and low stiffness is highly characteristic of a benign lesion [19,20] According to these data, we are considering including elastography parameters along with the conventional ultrasound parameters incorporated in the standard TI-RADS model, as this could increase the sensitivity and specificity of the standard TI-RADS.…”

Section: Introductionmentioning

confidence: 99%

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Strain Elastography as a Valuable Diagnosis Tool in Intermediate Cytology (Bethesda III) Thyroid Nodules

et al. 2019

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Fine needle aspiration (FNA) is considered the gold standard in the diagnostic of thyroid nodules. Using the recommended BETHESDA reporting system, up to 20% of results are classified as intermediate cytology. As there is no consensus whether ultrasound evaluation, lobectomy or surgery is the best treatment option, intermediate cytology results are considered a grey zone of the FNA. The main aim of our study was to evaluate the performance of combined advanced ultrasound techniques in the process of diagnosis and evaluation of the intermediate cytology cases after FNA. We evaluated 54 consecutive cases with intermediate cytology on FNA, using conventional B-mode ultrasound (2B), and strain elastography, using a linear multifrequency 6–13 MHz linear probe (Hitachi Prerius Machine, Hitachi Inc, Japan). All nodules were classified with our Thyroid Imaging Report and Data System (TI-RADS) proposed model, considering: vertical appearance, with antero-posterior diameter bigger than the transvers diameter, the so called taller than wide shape, irregular borders, intranodular inhomogeneity, marked hypoecogenicity, micro calcifications, the presence of suspect lymph nodes, and increased stiffness as suspicious for malignancy. The classification outcomes were compared with the pathology results, considered the gold standard diagnosis. The prevalence of cancer was 28.8%, with 13/45 cases having a clear diagnostic of cancer. Six cases were diagnosed with borderline follicular neoplasia, a category with unclear evolution, also considered as malignant in the analysis of the imaging results. In total, 16/19 cancer cases had increased stiffness on elastography. The cancer prevalence increased with TI-RADS category, being 25% in TI-RADS 4b category and 92.8% in TI-RADS 5 category. The AUROC (Area Under Receiver Operating Curve) of elastography alone, in differentiation of malignant thyroid nodules was 74.9%; the combination of elastographic and conventional ultrasound characteristics generated an even better AUROC, of 84.5%. The combined conventional ultrasound and elastography identified thyroid cancer in cases with intermediate cytology with a sensitivity of 89.5% with a specificity of 50%. High risk thyroid nodules, identified by combined high risk conventional ultrasound characteristics and increased stiffness, on strain elastography, are highly predictive for malignancy, in the intermediate cytology cases.

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Section: Discussionsupporting

confidence: 86%

Section: Introductionmentioning

confidence: 99%

Strain Elastography as a Valuable Diagnosis Tool in Intermediate Cytology (Bethesda III) Thyroid Nodules

et al. 2019

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“…[14] . When compared with the diagnostic indices of strain colour elasto score system versus strain ratio we found that the elasticity score overall accuracy was better than the strain ratio index which is comparable to the study done by Habib et al [15].…”

Section: Discussionsupporting

confidence: 85%

Role of Sonoelastography in Differentiating Benign and Malignant Thyroid Nodules

Brahmadathan¹

2019

jmscr

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Introduction: Thyroid nodules are a common medical problem seen in about 8.5% of the population. It is of clinical importance to diagnose malignant nodules from benign which do not require surgery and decide which patient should proceed to biopsy. Ultra sound elastography is a noninvasive technique to evaluate the tissue stiffness of the lesion .The present study aims to assess the sensitivity, specificity, positive and negative predictive value of Strain Elastography in differentiating benign and malignant thyroid nodules by comparing with histo pathological analysis as the reference standard. Materials and Methods: This study was a diagnostic test evaluation study involving 107 study subjects with palpable thyroid nodules who underwent ultrasound Strain elastography examination in Department of Radiodiagnosis for one year and six months.Strain elastography was performed and the nodules were classified into different elasticity scores according to the elasticity score developed by Itoh and Ueno. Scores 1,2&3 taken as benign and scores 4&5 were taken as malignant. Patients were followed up and their histopathological results after surgery were compared with the elastography findings. Sensitivity, specificity, positive predictive and negative predictive values were obtained. Also strain ratio was obtained for all lesions and a cut off value derived to aid in differentiating Malignant nodules from benign.. Results & Conclusion:Ultrasound strain elastography had a sensitivity of 90%, specificity of 94.3%, positive predictive value of 78.3% and negative predictive value of 97.6%.Strain ratio cut off of 3.96 derived which showed good diagnostic sensitivity, specificity and accuracy to differentiate malignant and benign nodules. Thus ultrasound Strain elastography scoring system and strain ratio found to be highly accurate in differentiating benign and malignant thyroid nodules.

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“…2 Few authors have also proposed that the use of thyroid elastography can potentially reduce the number of FNACs. 13,19 Should the PTM be validated in the future, there is a strong possibility that repeated FNAC may be reduced. The algorithm can potentially be applied to patients who are not keen on repeating a biopsy after an indeterminate or inconclusive cytology.…”

Section: Predictive Thyroid Modelmentioning

confidence: 99%

“…Even though they all have been shown to be an effective and independent predictor of malignancy, this has been disputed by some. 9,12,13 The main objective of this study is to look at the diagnostic accuracy of USE performed by endocrine surgeons at Hospital Canselor Tuanku Muhriz (HCTM) in detecting benign and malignant thyroid nodules. The secondary objectives of this study are to evaluate the performance of USE in combination with conventional ultrasounds, and to develop a predictive scoring system for thyroid nodules based on the findings.…”

Section: Introductionmentioning

confidence: 99%

Complementary Thyroid Elastography on Conventional Ultrasound in Diagnosis of Malignant Thyroid Nodules

Muhammed¹,

Suhaimi²,

Rashid

et al. 2022

imjm

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INTRODUCTION: Ultrasound has been widely used to assess thyroid nodules. Although ultrasound elastography has been developed to improve detection of thyroid malignancy, it has received mixed responses. This study aimed to determine the efficacy of ultrasound elastography in detecting malignant thyroid nodules. MATERIALS AND METHODS: Patients with thyroid nodules were assessed using conventional ultrasound and elastography followed by fine-needle aspiration and or hemithyroidectomy. The ultrasound findings were compared with the cytology or histopathology for statistical analysis. RESULTS: Out of 156 nodules from 92 patients included in the study, 12 (7.7%) were malignant and 144 (88.8%) were benign. The elastography was found to be an independent predictor of malignancy (OR 10.35, 95% CI [1.31, 81.6], p = 0.03). Other independent predictors were taller shape and central Doppler pattern obtained using conventional ultrasound. A combination of the three independent predictors was shown to improve the sensitivity of detecting malignant thyroid nodules up to 100%, 95% CI [73.5,100] with NPV of 100%. A new scoring system incorporating the three variables was developed and an algorithm using the scoring system was proposed. CONCLUSION: Thyroid elastography is an independent predictor of thyroid malignancy. Its performance is comparable to conventional ultrasound when used alone and improved when used in combination with conventional ultrasound. It is valuable as screening and risk-stratification tools for patients with thyroid nodules.

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Role of ultrasound elastography in assessment of indeterminate thyroid nodules

Cited by 9 publications

References 24 publications

Strain Elastography as a Valuable Diagnosis Tool in Intermediate Cytology (Bethesda III) Thyroid Nodules

Strain Elastography as a Valuable Diagnosis Tool in Intermediate Cytology (Bethesda III) Thyroid Nodules

Role of Sonoelastography in Differentiating Benign and Malignant Thyroid Nodules

Complementary Thyroid Elastography on Conventional Ultrasound in Diagnosis of Malignant Thyroid Nodules

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