Use of ultrasound elastography in differentiating benign from malignant thyroid nodules: a prospective study.

Autor: Shingare A; Department of Endocrinology, Lokmanya Tilak Municipal Medical College and General Hospital, Mumbai, India., Maldar AN; Department of Endocrinology, P. D. Hinduja Hospital and Medical Research Centre, Mumbai, India., Chauhan PH; Department of Endocrinology, P. D. Hinduja Hospital and Medical Research Centre, Mumbai, India., Wadhwani R; Department of Radiology, P. D. Hinduja Hospital and Medical Research Centre, Mumbai, India.
Jazyk: angličtina
Zdroj: Journal of diabetes and metabolic disorders [J Diabetes Metab Disord] 2023 May 31; Vol. 22 (2), pp. 1245-1253. Date of Electronic Publication: 2023 May 31 (Print Publication: 2023).
DOI: 10.1007/s40200-023-01239-9
Abstrakt: Purpose: Elastography is a real-time non-invasive ultrasonography modality wherein the tissue stiffness is evaluated by calculating the degree of tissue distortion in response to an external force. This study was undertaken to assess the diagnostic value of elastography in differentiating benign from malignant thyroid nodules.
Methodology: In this prospective comparative study, a total of 52 thyroid nodules from 44 euthyroid patients undergoing fine needle aspiration cytology were assessed. Elastography was performed by a single experienced sonologist, wherein the nodules were graded as per elastography scoring (ES), and the strain ratio (SR) for each nodule was computed. Final histopathology findings of the patients undergoing surgery were compared to elastography findings, and measures of diagnostic accuracy to differentiate between benign and malignant nodules were determined for ES and SR.
Results: Thirty (68.2%) females and 14 (31.8%) males, with a mean age of 45.18 ± 11.23 years, were assessed. Fourteen (31.8%) patients underwent thyroidectomy, and histopathology was reported for 18 (34.6%) nodules. In all, nine (17.3%) nodules were malignant, and 43 (82.7%) nodules were considered benign. ES demonstrated a sensitivity of 88.9%, specificity of 88.3%, PPV of 61.5%, NPV of 97.4%, and accuracy of 88.5% to identify benign thyroid nodules. The mean SR for benign nodules was significantly lower as compared to malignant nodules (2.72 ± 0.62 vs. 4.52 ± 0.75, P  < 0.0001). The optimal cut-point value for SR to differentiate benign and malignant thyroid nodules was determined to be 3.8, with the sensitivity, specificity, PPV, NPV, and accuracy being 88.9%, 95.4%, 80%, 94.6%, and 94.2%, respectively.
Conclusion: Ultrasound elastography (ES and SR) demonstrated good diagnostic efficacy to differentiate benign thyroid nodules from the malignant ones, and can be a good supplementary tool to gray-scale ultrasonography. It can also help in reducing the rates of unnecessary fine needle-aspiration biopsy.
Competing Interests: Competing interests/Conflicts of interestAll authors certify that they have no affiliations with or involvement in any organization or entity with any financial interest or non-financial interest in the subject matter or materials discussed in this manuscript.
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Databáze: MEDLINE
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