Diagnostic value of American College of Radiology Thyroid Imaging Reporting and Data System combined with elastography in differentiating clinically atypical subacute thyroiditis from papillary thyroid carcinoma: a single retrospective research

Background Common ultrasound imaging is hard to distinguish thyroid nodules of clinically atypical subacute thyroiditis (CAST) with papillary thyroid carcinoma (PTC). The purpose of this study was to investigate the diagnostic value of real-time elastography combined with American College of Radiolo...

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Bibliographic Details
Published in:Egyptian journal of radiology and nuclear medicine 2023-12, Vol.54 (1), p.214-10
Main Authors: Chen, Xiaoxue, Hu, Zhengming, Sun, Desheng, Luo, Haiyu, Zhao, Chenyang, Liao, Mengying
Format: Article
Language:English
Subjects:
Cancer
Carcinoma
Diagnostic imaging
Elasticity imaging technique
Histopathology
Hospitals
Physicians
Radiology
Radiology, Medical
Statistical analysis
Subacute
Thyroid cancer
Thyroiditis
TI-RADS
Ultrasonic imaging
Ultrasonography
Ultrasound imaging
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Summary:Background Common ultrasound imaging is hard to distinguish thyroid nodules of clinically atypical subacute thyroiditis (CAST) with papillary thyroid carcinoma (PTC). The purpose of this study was to investigate the diagnostic value of real-time elastography combined with American College of Radiology Thyroid Imaging Reporting and Data System (ACR-TIRADS) in differentiating these two lesions. Results Centripetal reduction echogenicity was only observed in the CAST nodules, with high specificity (100%) though low sensitivity (23.96%). Echogenic foci yielded good capability for differentiating PTC and CAST, with odds ratio (OR) of 36.572 and AUC of 0.788. Size and ES were independent factors to distinguish the two lesions with OR of 10.709 and 3.697, respectively. The combination of microcalcification, size < 10 mm and ES of 4 showed better AUC (0.885) than echogenic foci alone (p < 0.001). TI-RADS showed high sensitivity (91.23%) with specificity of 30.21% and AUC of 0.607 in predicting malignancy risk of PTC from CAST, while the AUC of ES and the combination of both methods were 0.508 and 0.585, respectively. Conclusions Centripetal reduction echogenicity, echogenic foci, size and ES may assist in the differential diagnosis of CAST and PTC nodules. ACR TI-RADS is superior to ES and the combination of both methods for distinguishing these two lesions.
ISSN:0378-603X
2090-4762
DOI:10.1186/s43055-023-01159-x