Diagnostic Performance of Shear Wave Elastography Parameters Alone and in Combination with Conventional B-Mode Ultrasound Parameters for the Characterization of Thyroid Nodules: A Prospective, Dual-Center Study
| Autor: | Paweł Wareluk, Anna Gumińska, Elwira Bakuła Zalewska, Krzysztof Mlosek, Rafal Z. Slapa, Wiesław Jakubowski, Katarzyna Dobruch-Sobczak, Marek Dedecjus |
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| Rok vydání: | 2016 |
| Předmět: |
Adult
Male Thyroid nodules medicine.medical_specialty Acoustics and Ultrasonics Thyroid Gland Biophysics Sensitivity and Specificity 030218 nuclear medicine & medical imaging Diagnosis Differential Autoimmune thyroiditis Young Adult 03 medical and health sciences 0302 clinical medicine Region of interest Humans Medicine Radiology Nuclear Medicine and imaging Prospective Studies Thyroid Nodule Generalized estimating equation Aged Ultrasonography Aged 80 and over Radiological and Ultrasound Technology Receiver operating characteristic business.industry Thyroid Ultrasound Area under the curve Reproducibility of Results Middle Aged medicine.disease medicine.anatomical_structure 030220 oncology & carcinogenesis Elasticity Imaging Techniques Female Radiology business |
| Zdroj: | Ultrasound in Medicine & Biology. 42:2803-2811 |
| ISSN: | 0301-5629 |
| DOI: | 10.1016/j.ultrasmedbio.2016.07.010 |
| Popis: | The aims of our study were to determine whether shear wave elastography (SWE) can improve the conventional B-mode differentiation of thyroid lesions, determine the most accurate SWE parameter for differentiation and assess the influence of microcalcifications and chronic autoimmune thyroiditis on SWE values. We examined 119 patients with 169 thyroid nodules who prospectively underwent B-mode ultrasound and SWE using the same ultrasound machine. The parameters assessed using SWE were: mean elasticity within the entire lesion (SWE-whole) and mean (SWE-mean) and maximum (SWE-max) elasticity for a 2-mm-diameter region of interest in the stiffest portion of the lesion, excluding microcalcifications. The discriminant powers of a generalized estimating equation model including B-mode parameters only and a generalized estimation equation model including both B-mode and SWE parameters were assessed and compared using the area under the receiver operating characteristic curve, in association with pathologic verification. In total, 50 and 119 malignant and benign lesions were detected. In generalized estimated equation regression, the B-mode parameters associated with higher odds ratios (ORs) for malignant lesions were microcalcifications (OR = 4.3), hypo-echogenicity (OR = 3.13) and irregular margins (OR = 10.82). SWE-max was the only SWE independent parameter in differentiating between malignant and benign tumors (OR = 2.95). The area under the curve for the B-mode model was 0.85, whereas that for the model combining B-mode and SWE parameters was 0.87. There was no significant difference in mean SWE values between patients with and without chronic autoimmune thyroiditis. The results of the present study suggest that SWE is a valuable tool for the characterization of thyroid nodules, with SWE-max being a significant parameter in differentiating benign and malignant lesions, independent of conventional B-mode parameters. The combination of SWE parameters and conventional B-mode parameters does not significantly improve the diagnosis of malignant thyroid nodules. The presence of microcalcifications can influence the SWE-whole value, whereas the presence of chronic autoimmune thyroiditis may not. |
| Databáze: | OpenAIRE |
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