Elastography for the Diagnosis of High-Suspicion Thyroid Nodules Based on the 2015 American Thyroid Association Guidelines: A Multicenter Study
| Autor: | Ma Buyun, Gan Kehong, Tian Jiawei, Wang Yan, Jiang Shuang-quan, Peng Yu-lan, Chen Haitao, Li Yi, Liu Lisha, Zhou Xiaodong, Li Liang, Liu Wenying, Li Hairu, Tang Ling, Yang Lichun, Yan Kun, Gong Xue, Ai Hong, Cong Shuzhen, Lv Xiaoyu, Yong Qiang, Xiao Ying, Luo Bao-ming, Zhang Xixi, Zhao Xinbao, Fu Xin |
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| Rok vydání: | 2020 |
| Předmět: |
Thyroid nodules
Adult Male medicine.medical_specialty Endocrinology Diabetes and Metabolism Logistic regression Malignancy lcsh:Diseases of the endocrine glands. Clinical endocrinology 030218 nuclear medicine & medical imaging 03 medical and health sciences 0302 clinical medicine Cytology Ultrasound Medicine Humans Thyroid Neoplasms Thyroid Nodule Cancer Thyroid lcsh:RC648-665 medicine.diagnostic_test Receiver operating characteristic business.industry General Medicine Middle Aged medicine.disease Prognosis medicine.anatomical_structure 030220 oncology & carcinogenesis Practice Guidelines as Topic Elasticity Imaging Techniques Female Elastography Radiology business Research Article Follow-Up Studies |
| Zdroj: | BMC Endocrine Disorders, Vol 20, Iss 1, Pp 1-10 (2020) BMC Endocrine Disorders |
| DOI: | 10.21203/rs.2.17002/v3 |
| Popis: | Background An accurate diagnosis for high-suspicion nodules based on the 2015 American Thyroid Association (ATA) guidelines would reduce unnecessary invasive examinations. Elastography is a useful tool for discriminating benign and malignant thyroid nodules. The aim of this study is to investigate the diagnostic efficiency of elastography for high-suspicion thyroid nodules based on the 2015 ATA guidelines in the Chinese population. Methods Thyroid nodules with high-suspicion characteristics based on the 2015 ATA guidelines were subjected to conventional ultrasound (US) and ultrasound strain elastography (USE) examinations at 12 hospitals from 4 geographic regions across China. Cytology/histology of thyroid nodules was used as a reference method. Receiver operating characteristic (ROC) curves were plotted to evaluate the diagnostic performance of the elasticity score (ES) and strain ratio (SR). Logistic regression analysis was used to determine the predictors of malignancy. Results Overall, a total of 1445 thyroid nodules (834 malignant, 611 benign) from 12 centers were included in the final analysis. The areas under the curve of the ES and SR were 0.828 and 0.732, respectively. The sensitivity, specificity, accuracy, positive predictive value (PPV) and negative predictive value (NPV) of the ES were 92.4, 60.7, 79.0, 76.3 and 85.5%, respectively, and those of the SR were 81.1, 50.1, 68.9, 65.9 and 67.9%, respectively. The combination of the Thyroid Imaging Reporting and Data System (TI-RADS) and ES led to a significant increase in the sensitivity and NPV (97.1 and 91.9%, respectively) compared with the TI-RADS alone. Logistic regression analysis showed that microcalcifications (OR = 5.290), taller than wide (OR = 12.710), irregular margins (OR = 10.117), extrathyroidal extension (ETE; OR = 6.412), the ES (OR = 3.741) and the SR (OR = 1.083) were independent predictors of malignant thyroid nodules. The sensitivity, specificity, accuracy, PPV and NPV of the ES were all superior in nodules ≥1 cm than in those Conclusions Elastography combined with the ES is a valuable tool for the assessment of high-suspicion thyroid nodules based on the 2015 ATA guidelines, especially in nodules ≥1 cm. |
| Databáze: | OpenAIRE |
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