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Vol 68, No 6 (2017)
Original paper
Submitted: 2017-03-26
Accepted: 2017-05-23
Published online: 2017-09-18
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The efficiency of elastography in the diagnostics of follicular lesions and nodules with an unequivocal FNA result

Martyna Wojtaszek-Nowicka1, Dorota Słowińska-Klencka1, Stanisław Sporny2, Bożena Popowicz1, Krzysztof Kuzdak3, Lech Pomorski4, Krzysztof Kaczka4, Jan Sopiński3, Mariusz Klencki1
DOI: 10.5603/EP.a2017.0050
·
Pubmed: 29022643
·
Endokrynol Pol 2017;68(6):610-622.
Affiliations
  1. Department of Morphometry of Endocrine Glands, Chair of Endocrinology, Medical University of Lodz, Lodz, Poland
  2. Department and Chair of Pathomorphology, Medical University of Lodz, Lodz, Poland
  3. Department of Endocrinological, General and Oncological Surgery, Chair of Endocrinology, Medical University of Lodz, Lodz, Poland
  4. Department of General and Oncological Surgery, Chair of Surgical Clinical Sciences, Medical University, Lodz, Lodz, Poland

open access

Vol 68, No 6 (2017)
Original Paper
Submitted: 2017-03-26
Accepted: 2017-05-23
Published online: 2017-09-18

Abstract

Introduction: The aim was to assess the usefulness of strain elastography (SEG) in the diagnostics of two groups of thyroid nodules (TNs): follicular lesions (FL) with low malignancy risk (< 20.0%) and low percentage of papillary carcinomas (PTCs) among cancers as well as TNs with unequivocal cytology (UC) and high percentage of PTCs among cancers. Material and methods: 168 TNs were analysed and eventually surgically treated: 100 UC (50 benign and 50 malignant — 90.0% PTCs) and 68 FL (60 benign, 8 malignant — 50.0% PTCs). Elasticity score (ES) and strain ratio (SR) were evaluated, and their effectiveness was compared with the evaluation of the number of ultrasound malignancy risk features (NoUMRFs). Results: In the UC group the evaluation of mean values of SR and ES in both sections (meanSR, meanES) was more efficient than NoUMRFs analysis (AUC: 0.903 and 0.869 vs. 0.754, p < 0.05). The following thresholds: meanSR ≥ 2.01, meanES ≥ 2.5, NoUMRFs ≥ 2, were related to the increased malignancy risk in nodules (OR: 45.0; 23.2; 5.4, respectively), but only meanSR ≥ 2.01 was an independent risk factor (OR: 20.3; SEN: 86.0%, SPC: 88.0%). In the FL group, only the evaluation of tSR (SR assessed in transverse section) had the value of AUC > 0.7, and only the set of features: tSR ≥ 1.7 and NoUMRFs ≥ 1 increased the malignancy risk in nodules (OR: 12.0; SEN: 75.0%, SPC: 75.0%). Conclusions: SEG is more reliable than conventional US in the diagnostics of TNs. The efficacy of SEG decreases with lowering percentage of PTCs among cancers. But in FL nodules SEG may support the selection of nodules for surgical treatment.  

Abstract

Introduction: The aim was to assess the usefulness of strain elastography (SEG) in the diagnostics of two groups of thyroid nodules (TNs): follicular lesions (FL) with low malignancy risk (< 20.0%) and low percentage of papillary carcinomas (PTCs) among cancers as well as TNs with unequivocal cytology (UC) and high percentage of PTCs among cancers. Material and methods: 168 TNs were analysed and eventually surgically treated: 100 UC (50 benign and 50 malignant — 90.0% PTCs) and 68 FL (60 benign, 8 malignant — 50.0% PTCs). Elasticity score (ES) and strain ratio (SR) were evaluated, and their effectiveness was compared with the evaluation of the number of ultrasound malignancy risk features (NoUMRFs). Results: In the UC group the evaluation of mean values of SR and ES in both sections (meanSR, meanES) was more efficient than NoUMRFs analysis (AUC: 0.903 and 0.869 vs. 0.754, p < 0.05). The following thresholds: meanSR ≥ 2.01, meanES ≥ 2.5, NoUMRFs ≥ 2, were related to the increased malignancy risk in nodules (OR: 45.0; 23.2; 5.4, respectively), but only meanSR ≥ 2.01 was an independent risk factor (OR: 20.3; SEN: 86.0%, SPC: 88.0%). In the FL group, only the evaluation of tSR (SR assessed in transverse section) had the value of AUC > 0.7, and only the set of features: tSR ≥ 1.7 and NoUMRFs ≥ 1 increased the malignancy risk in nodules (OR: 12.0; SEN: 75.0%, SPC: 75.0%). Conclusions: SEG is more reliable than conventional US in the diagnostics of TNs. The efficacy of SEG decreases with lowering percentage of PTCs among cancers. But in FL nodules SEG may support the selection of nodules for surgical treatment.  

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Keywords

elastography, thyroid, follicular lesion, fine-needle aspiration biopsy, thyroid cancer

About this article
Title

The efficiency of elastography in the diagnostics of follicular lesions and nodules with an unequivocal FNA result

Journal

Endokrynologia Polska

Issue

Vol 68, No 6 (2017)

Article type

Original paper

Pages

610-622

Published online

2017-09-18

Page views

1268

Article views/downloads

1028

DOI

10.5603/EP.a2017.0050

Pubmed

29022643

Bibliographic record

Endokrynol Pol 2017;68(6):610-622.

Keywords

elastography
thyroid
follicular lesion
fine-needle aspiration biopsy
thyroid cancer

Authors

Martyna Wojtaszek-Nowicka
Dorota Słowińska-Klencka
Stanisław Sporny
Bożena Popowicz
Krzysztof Kuzdak
Lech Pomorski
Krzysztof Kaczka
Jan Sopiński
Mariusz Klencki

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