Combination of contrast-enhanced ultrasound and strain elastography to assess cytologically non-diagnostic thyroid nodules

• Published in: Oncology letters 2019-12, Vol.18 (6), p.6845-6851
• Main Authors: Lin, Zi-Mei, Wen, Qing, Yan, Cao-Xin, Pan, Min-Qiang, Mo, Guo-Qiang, Chen, Ji-Fan, Huang, Pin-Tong
• Format: Article
• Language: English
• Subjects: Accuracy; Cellular biology; Elasticity; Lymphatic system; Medical diagnosis; Medical prognosis; Metastasis; Oncology; Patients; Thyroid cancer; Ultrasonic imaging
• ISSN: 1792-1074; 1792-1082
• DOI: 10.3892/ol.2019.11058

The aim of the present study was to investigate the benefits of combining contrast-enhanced ultrasound (CEUS) and strain elastography (SE) for the diagnosis of thyroid nodules with non-diagnostic fine-needle aspiration cytology (FNAC) results. Between October 2013 and March 2017, CEUS and SE were performed in 226 patients (236 thyroid nodules) with non-diagnostic FNAC results prior to thyroidectomy. The diagnostic value of CEUS, SE and their combination (CEUS+SE) in distinguishing malignant from benign thyroid nodules was evaluated, using surgical pathology as a reference. Receiver operating characteristic curve analysis was used to assess the diagnostic performance of CEUS, SE and CEUS+SE in determining malignant thyroid nodules. Subsequently, the sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and accuracy of CEUS, SE and CEUS + SE were calculated. The malignancy rate in patients with thyroid nodules and non-diagnostic FNAC results was 26.3% in the present study. The sensitivity, specificity, PPV, NPV, accuracy and area under the curve in predicting malignant thyroid nodules were 80.6, 85.6, 66.7, 92.5, 84.3 and 0.831%, respectively, using SE alone; 59.7, 95.9, 84.1, 86.9, 86.4 and 0.778%, respectively, using CEUS alone; and 83.9, 89.1, 73.6, 94.5, 88.1 and 0.865%, respectively, using the combination of CEUS and SE. Overall, the combination of CEUS with SE resulted in higher sensitivity, NPV and accuracy in the diagnosis of cytologically non-diagnostic thyroid nodules compared with CEUS or SE alone.