Shear wave elastography of thyroid nodules in routine clinical practice: preliminary observations and utility for detecting malignancy

• Published in: European radiology 2012-11, Vol.22 (11), p.2397-2406
• Main Authors: Bhatia, Kunwar S. S., Tong, Cina S. L., Cho, Carmen C. M., Yuen, Edmund H. Y., Lee, Yolanda Y. P., Ahuja, Anil T.
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Aged; Aged, 80 and over; Biopsy; Biopsy, Fine-Needle; Cell Biology; Cellular biology; Child; Clinical medicine; Diagnostic Radiology; Elasticity Imaging Techniques - methods; Female; Head and Neck; Humans; Imaging; Internal Medicine; Interventional Radiology; Male; Medicine; Medicine & Public Health; Middle Aged; Neuroradiology; Prospective Studies; Radiology; Reproducibility of Results; Sensitivity and Specificity; Shear Strength; Stress, Mechanical; Thyroid diseases; Thyroid Gland - pathology; Thyroid Neoplasms - diagnosis; Thyroid Neoplasms - pathology; Thyroid Nodule - diagnosis; Thyroid Nodule - pathology; Ultrasonic imaging; Ultrasound
• ISSN: 0938-7994; 1432-1084
• DOI: 10.1007/s00330-012-2495-1

Objective To evaluate real-time shear wave ultrasound elastography (SWE) for characterizing focal thyroid lesions in routine clinical practice. Methods Seventy-four patients with 81 focal thyroid lesions undergoing conventional US with needle cytology also underwent SWE. Absolute and relative SWE stiffness measurements on colour-coded elastograms were correlated with cytology and their discriminatory performances assessed. Results Seventeen nodules were malignant (13 papillary, 4 other cancers), 45 benign (43 hyperplastic nodules, 2 focal thyroiditis), 5 indeterminate (“follicular lesions”), and 5 had inadequate cytology. SWE results were higher in malignant than benign nodules ( P values 0.02–0.05) although their discriminatory performances were mediocre (AUCs 0.58–0.74). The most accurate SWE cut-off, 34.5 kPa for a 2-mm region of interest, achieved 76.9 % sensitivity and 71.1 % specificity for discriminating papillary cancer from benign nodules. No thresholds produced high sensitivity without lowering specificity appreciably, and vice versa. Nodule size correlated with SWE for benign nodules ( P