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Real-time ultrasound elastography - a new tool for diagnosing thyroid nodules
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Abstract
Introduction: Real-time elastography (RTE) is a non-invasive ultrasound method of estimation of tissue stiffness by measuring the degree of local tissue displacements after a small compression. Recent data has shown its ability to differentiate benign from malignant tumours. The aim of this study was to evaluate the accuracy of RTE in the diagnosis of malignant and benign thyroid nodules.
Material and methods: 71 thyroid nodules in 52 patients: 42 females and 10 males aged 28-77 were examined using conventional ultrasonography (US), fine-flow CD imaging and RTE. All nodules previously underwent fine-needle aspiration biopsy (FNAB), and patients with malignant and suspicious cytological results were referred for surgery. The final diagnosis was based on FNAB results in patients with benign cytology and on the histopathology reading in those who underwent surgery. An elasticity score (ES) from 1 to 5 was determined for each nodule according to the Ueno classification.
Results: An elasticity score (ES) of 4 or 5 was found in 19 out of 22 (86.5%) thyroid cancers and in only 1 out of 31 (3%) benign nodules. This was strongly indicative for malignancy (p < 0.0001) with sensitivity 86%, specificity 97%, positive predictive value (PPV) 95% and negative predictive value (NPV) 91%.
Conclusions: RTE is a highly sensitive and specific method of diagnosing thyroid nodules. This technique can be employed in selecting thyroid nodules for fine-needle aspiration biopsy.
(Pol J Endocrinol 2010; 61 (6): 652-657)
Abstract
Introduction: Real-time elastography (RTE) is a non-invasive ultrasound method of estimation of tissue stiffness by measuring the degree of local tissue displacements after a small compression. Recent data has shown its ability to differentiate benign from malignant tumours. The aim of this study was to evaluate the accuracy of RTE in the diagnosis of malignant and benign thyroid nodules.
Material and methods: 71 thyroid nodules in 52 patients: 42 females and 10 males aged 28-77 were examined using conventional ultrasonography (US), fine-flow CD imaging and RTE. All nodules previously underwent fine-needle aspiration biopsy (FNAB), and patients with malignant and suspicious cytological results were referred for surgery. The final diagnosis was based on FNAB results in patients with benign cytology and on the histopathology reading in those who underwent surgery. An elasticity score (ES) from 1 to 5 was determined for each nodule according to the Ueno classification.
Results: An elasticity score (ES) of 4 or 5 was found in 19 out of 22 (86.5%) thyroid cancers and in only 1 out of 31 (3%) benign nodules. This was strongly indicative for malignancy (p < 0.0001) with sensitivity 86%, specificity 97%, positive predictive value (PPV) 95% and negative predictive value (NPV) 91%.
Conclusions: RTE is a highly sensitive and specific method of diagnosing thyroid nodules. This technique can be employed in selecting thyroid nodules for fine-needle aspiration biopsy.
(Pol J Endocrinol 2010; 61 (6): 652-657)
Keywords
thyroid nodule; elastography; ultrasonography
About this articleTitle
Real-time ultrasound elastography - a new tool for diagnosing thyroid nodules
Journal
Issue
Article type
Original paper
Pages
652-657
Published online
2010-11-15
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Bibliographic record
Endokrynol Pol 2010;61(6):652-657.
Keywords
thyroid nodule
elastography
ultrasonography
Authors
Małgorzata Gietka-Czernel
Magdalena Kochman
Karolina Bujalska
Elżbieta Stachlewska-Nasfeter
Wojciech Zgliczyński
