Efficacy of differential diagnosis of thyroid nodules by shear wave elastography - The Stiffness Map
- Authors
- Yoo, M.H.; Kim, H.J.; Choi, I.H.; Park, S.; Yun, S.; Park, H.K.; Byun, D.W.; Suh, K.
- Issue Date
- 1-Nov-2021
- Publisher
- Endocrine Society
- Keywords
- Differential diagnosis; Elastography; Shear wave; Thyroid nodule
- Citation
- Journal of the Endocrine Society, v.5, no.11
- Journal Title
- Journal of the Endocrine Society
- Volume
- 5
- Number
- 11
- URI
- https://scholarworks.bwise.kr/cau/handle/2019.sw.cau/62050
- DOI
- 10.1210/jendso/bvab154
- ISSN
- 2472-1972
2472-1972
- Abstract
- Background: Fine needle aspiration is the gold standard for differential diagnosis of thyroid nodules; however, the malignancy rate for indeterminate cytology is 20% to 50%. Objective: We evaluated the efficacy of shear wave elastography added to ultrasonography for differential diagnosis of thyroid nodules. Methods: We retrospectively reviewed the medical records of 258 consecutive patients. Thyroid nodules were divided into 4 categories according to maximum elasticity (EMax) and nodule depth/width (D/W) ratio: Category 1 (EMax ≥ 42.6 kPa; D/W < 0.9); Category 2 (EMax < 42.6 kPa; D/W < 0.9); Category 3 (EMax ≥ 42.6 kPa; D/W ≥ 0.9); and Category 4 (EMax < 42.6 kPa; D/W ≥ 0.9). The EMax cutoff value was set using receiver operating characteristic (ROC) curve analysis to predict nodular hyperplasia (NH) vs follicular neoplasm (FN). Cutoff value for nodule D/W ratio was set using ROC curve analysis for malignancy. Results: NH was the most prevalent pathology group in Category 1, FN in Category 2, and papillary thyroid carcinoma in Category 3. Category 3 demonstrated the highest rate of malignancy (81.8%) and had 55.4% sensitivity and 90% specificity for predicting malignancy. When assessing the benign pathology of NH in follicular patterned lesion, Category 1 demonstrated the highest NH prevalence of 88.9% (34/37) and had 73.9% sensitivity and 85.0% specificity. Conclusion: The performance for malignancy was highest in Category 3 and predictive ability for benign pathology of NH in follicular lesion was highest in Category 1. The information of EMax and nodule D/W ratio was useful to predict the pathology of thyroid nodules. © 2021 The Author(s) 2021.
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