Summary of meta-analyses of studies considering lesion size cut-off thresholds for the assessment of eligibility for FNAB and sonoelastography and inter- and intra-observer agreement in estimating the malignant potential of focal lesions of the thyroid gland

Abstract

Thyroid cancer is a tumour with a steadily increasing incidence. It accounts for 7% to 15% of focal lesions detected by ultrasound, depending on age, gender and other factors affecting its occurrence. Fine-needle aspiration biopsy is an essential method to establish the diagnosis but, in view of its limitations, sonoelastography is seen as a non-invasive technique useful in differentiating the nature of lesions and monitoring them after fine-needle aspiration biopsy. This paper presents a literature review on the role of both sonoelastographic techniques (relative strain sonoelastography, shear wave sonoelastography) to assess the deformability of focal thyroid lesions. Ultrasound examination is a relatively subjective method of thyroid imaging, depending on the skills of the examiner, the experience of the centre, and the quality of equipment used. As a consequence, there are inconsistencies between the results obtained by different examiners (inter-observer variability) and by the same examiner (intra-observer variability). In this paper, the authors present a review of the literature on inter-observer and intra-observer variability in the assessment of individual features of ultrasound imaging of focal lesions in the thyroid. In addition, the authors report on an analysis of cut-off thresholds for the size of lesions constituting the basis for fine-needle aspiration biopsy eligibility assessment. The need to diagnose carcinomas up to 10 mm in diameter is highlighted, however a more liberal approach is recommended in terms of indications for biopsy in lesions associated with a low risk of malignancy, where, based on consultations with patients, active ultrasound surveillance might even be considered.

Tiroid nodüllerinin benign ve malign ayırıcı tanısında gerçek zamanlı elastografinin etkinliğinin araştırılması

“…Scoring made on the color map is subjective, and despite different scoring systems, inter-observer agreement is not sufficient. In their meta-analysis study, Dobruch-Sobczak et al stated that there are inconsistencies between the results obtained by different examiners (inter-observer variability) and by the same examiner (intra-observer variability) in performing sonoelastographic techniques such as relative strain sonoelastography and shear wave sonoelastography (25). In our study, real-time examinations were performed by a single radiologist (LT).…”

Effectiveness of Two-Dimensional Shear-Wave Sonoelastography in the Diagnosis and Follow-up of Infantile Hypertrophic Pyloric Stenosis

“…USE is also widely used with thyroid diseases [33,34]; the elasticity of palpable and non-palpable nodules can be evaluated with USE, making it useful as an auxiliary test to differentiate benign from malignant thyroid tumors [35,36]. Chronic kidney disease, renal brosis, renal tumors, diabetic renal disease, and urogenital, pancreatic, prostate, and spleen diseases can also be evaluated with USE techniques [11,12,[37][38][39][40].…”

Effectiveness of two-dimensional shear-wave sonoelastography in the diagnosis and follow-up of infantile hypertrophic pyloric stenosis

“…USE is also widely used with thyroid diseases [ 33 , 34 ]; the elasticity of palpable and non-palpable nodules can be evaluated with USE, making it useful as an auxiliary test to differentiate benign from malignant thyroid tumors [ 35 , 36 ]. Chronic kidney disease, renal fibrosis, renal tumors, diabetic renal disease, and urogenital, pancreatic, prostate, and spleen diseases can also be evaluated with USE techniques [ 11 , 12 , 37 – 40 ].…”