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

2012 ◽  
Vol 22 (11) ◽  
pp. 2397-2406 ◽  
Author(s):  
Kunwar S. S. Bhatia ◽  
Cina S. L. Tong ◽  
Carmen C. M. Cho ◽  
Edmund H. Y. Yuen ◽  
Yolanda Y. P. Lee ◽  
...  
Keyword(s):  
Clinical Practice ◽  
Shear Wave ◽  
Thyroid Nodules ◽  
Shear Wave Elastography ◽  
Routine Clinical Practice

scholarly journals Shear Wave Elasticity by Tracing Total Nodule Showed High Reproducibility and Concordance with Fibrosis in Thyroid Cancer

2019 ◽  
Author(s):  
Myung Hi Yoo(New Corresponding Author) ◽  
Hye Jeong Kim(Former Corresponding Author) ◽  
In Ho Choi ◽  
Suyeon Park ◽  
Sang Jin Kim ◽  
...  
Keyword(s):  
Thyroid Cancer ◽  
Clinical Practice ◽  
Shear Wave ◽  
Thyroid Nodules ◽  
Intraclass Correlation ◽  
Region Of Interest ◽  
Shear Wave Elastography ◽  
Circular Area ◽  
High Reproducibility ◽  
Wide Range

Abstract Background Although shear wave elastography (SWE) is reported to be useful in detecting malignant thyroid nodules, it shows a wide range of cut-off values of elasticity index (EI) in detecting malignant nodules. The cause of discrepancy remains unclear. Fibrosis of the tumors is known to increase the EI in SWE, and matching of SWE and surgical histopathology has not been fully illustrated in thyroid cancer. We aimed to evaluate the reproducibility of the new total nodular region of interest (ROI) method excluding the subjective features of focal circular ROI placement and to determine the lesion that causes the elevation of EI on SWE and on histopathology. Methods A total of 29 thyroid cancers from 28 patients were included. We evaluated the reproducibility of EI in the new total nodular ROI using Q-Box Trace program and compared the EI in focal nodular ROI using a 3-mm circular area. We analyzed the correlation between fibrosis and EI. Result The coefficient of variation (CV) of the intrarater assay was significantly lower in total nodular ROI than in focal nodular ROI within the image in rater 1 (1.7% vs. 13.4%, p<0.001) and in rater 2 (1.4% vs. 16.9%, p<0.001) and in different images in rater 1 (7.6% vs. 12.3%, p=0.040) and in rater 2 (7.5% vs. 19.8%, p=0.004). Moreover, CV of the interrater assay showed similar results (14.9% vs. 19%, p=0.030). Interrater intraclass correlation coefficient showed better agreement in total nodular ROI than in focal nodular ROI (0.863 vs. 0.783). The degree of fibrosis on histopathology showed significant correlations with EI (E Mean , p<0.001; E Max , p=0.027), and the location of fibrosis was concordant with the high EI area on SWE. Conclusion Our study revealed that the new total nodular ROI method showed higher reproducibility and better agreement in intra- and interrater assay than the focal nodular ROI method, suggesting a valuable and standardized method in clinical practice. Moreover, our results showed that fibrosis in the histopathology increased EI on SWE and might lead to the discrepancy of the cut-off values in detecting thyroid cancer.

scholarly journals Shear Wave Elasticity by Tracing Total Nodule Showed High Reproducibility and Concordance with Fibrosis Leading to Discrepant Cut-off Values in Thyroid Cancer

2019 ◽  
Author(s):  
Myung Hi Yoo ◽  
Hye Jeong Kim ◽  
In Ho Choi ◽  
Suyeon Park ◽  
Sang Jin Kim ◽  
...  
Keyword(s):  
Thyroid Cancer ◽  
Clinical Practice ◽  
Shear Wave ◽  
Thyroid Nodules ◽  
Intraclass Correlation ◽  
Region Of Interest ◽  
Shear Wave Elastography ◽  
Circular Area ◽  
High Reproducibility ◽  
Wide Range

Abstract Background Although shear wave elastography (SWE) is reported to be useful in detecting malignant thyroid nodules, it showed a wide range of cut-off values of elasticity index (EI) in detecting malignant nodules. The cause of discrepancy has not been clarified yet. Fibrosis of the tumors is known to increase the EI in SWE, and matching of SWE and surgical histopathology has not been fully illustrated in thyroid cancer. We aimed to evaluate the reproducibility of the new total nodular region of interest (ROI) method excluding the subjective features of focal circular ROI placement and to determine the lesion that causes the elevation of EI on SWE and on histopathology. Methods A total of 29 thyroid cancers from 28 patients were included. We evaluated the reproducibility of EI in the new total nodular ROI using Q-Box Trace program and compared the EI in focal nodular ROI using a 3-mm circular area. We analyzed the correlation between fibrosis and EI. Result The coefficient of variation (CV) of the intrarater assay was significantly lower in total nodular ROI than in focal nodular ROI within the image in rater 1 (1.7% vs. 13.4%, p<0.001) and in rater 2 (1.4% vs. 16.9%, p<0.001) and in different images in rater 1 (7.6% vs. 12.3%, p=0.040) and in rater 2 (7.5% vs. 19.8%, p=0.004). Moreover, CV of the interrater assay showed similar results (14.9% vs. 19%, p=0.030). Interrater intraclass correlation coefficient showed better agreement in total nodular ROI than in focal nodular ROI (0.863 vs. 0.783). The degree of fibrosis on histopathology showed significant correlations with EI (EMean, p<0.001; EMax, p=0.027), and the location of fibrosis was concordant with the high EI area on SWE. Conclusion Our study revealed that the new total nodular ROI method showed higher reproducibility and better agreement in intra- and interrater assay than the focal nodular ROI method, suggesting a new, valuable, and standardized method in clinical practice. Moreover, our results showed that causes the elevation of EI leading to wide discrepant cut-off values of thyroid cancer was the formation of fibrosis.

scholarly journals Shear Wave Elasticity by Tracing Total Nodule Showed High Reproducibility and Concordance with Fibrosis in Thyroid Cancer

2019 ◽  
Author(s):  
Myung Hi Yoo ◽  
Hye Jeong Kim ◽  
In Ho Choi ◽  
Suyeon Park ◽  
Sang Jin Kim ◽  
...  
Keyword(s):  
Thyroid Cancer ◽  
Clinical Practice ◽  
Shear Wave ◽  
Thyroid Nodules ◽  
Intraclass Correlation ◽  
Region Of Interest ◽  
Shear Wave Elastography ◽  
Circular Area ◽  
High Reproducibility ◽  
Wide Range

Abstract Background Although shear wave elastography (SWE) is reported to be useful in detecting malignant thyroid nodules, it showed a wide range of cut-off values of elasticity index (EI) in detecting malignant nodules. The cause of discrepancy has not been clarified yet. Fibrosis of the tumors is known to increase the EI in SWE, and matching of SWE and surgical histopathology has not been fully illustrated in thyroid cancer. We aimed to evaluate the reproducibility of the new total nodular region of interest (ROI) method excluding the subjective features of focal circular ROI placement and to determine the lesion that causes the elevation of EI on SWE and on histopathology. Methods A total of 29 thyroid cancers from 28 patients were included. We evaluated the reproducibility of EI in the new total nodular ROI using Q-Box Trace program and compared the EI in focal nodular ROI using a 3-mm circular area. We analyzed the correlation between fibrosis and EI. Result The coefficient of variation (CV) of the intrarater assay was significantly lower in total nodular ROI than in focal nodular ROI within the image in rater 1 (1.7% vs. 13.4%, p<0.001) and in rater 2 (1.4% vs. 16.9%, p<0.001) and in different images in rater 1 (7.6% vs. 12.3%, p=0.040) and in rater 2 (7.5% vs. 19.8%, p=0.004). Moreover, CV of the interrater assay showed similar results (14.9% vs. 19%, p=0.030). Interrater intraclass correlation coefficient showed better agreement in total nodular ROI than in focal nodular ROI (0.863 vs. 0.783). The degree of fibrosis on histopathology showed significant correlations with EI (EMean, p<0.001; EMax, p=0.027), and the location of fibrosis was concordant with the high EI area on SWE. Conclusion Our study revealed that the new total nodular ROI method showed higher reproducibility and better agreement in intra- and interrater assay than the focal nodular ROI method, suggesting a valuable and standardized method in clinical practice. Moreover, our results showed that fibrosis in the histopathology increased EI on SWE and might lead to the discrepancy of the cut-off values in detecting thyroid cancer.

Diagnotic value of Shear Wave Elastography in differentiating parathyroid adenomas from thyroid nodules

2019 ◽  
Author(s):  
Mihaela Vlad ◽  
Ioana Golu ◽  
Maria Oprea ◽  
Daniela Amzar ◽  
Melania Balas ◽  
...  
Keyword(s):  
Shear Wave ◽  
Thyroid Nodules ◽  
Shear Wave Elastography ◽  
Parathyroid Adenomas

Diagnostic Value of Real-Time Shear Wave Elastography in Diagnosing Thyroid Cancer

2018 ◽  
Vol 68 (12) ◽  
pp. 2818-2822
Author(s):  
Maria Cristina Oprea ◽  
Mihaela Vlad ◽  
Ioana Golu ◽  
Ioan Sporea ◽  
Lazar Fulger
Keyword(s):  
Shear Wave ◽  
Predictive Value ◽  
Thyroid Nodules ◽  
Imaging Techniques ◽  
Area Under The Curve ◽  
Thyroid Volume ◽  
Shear Wave Elastography ◽  
Maximum Diameter ◽  
Diagnostic Tools ◽  
Tissue Elasticity

Thyroid nodules are a common pathology found in 50 to 60% of otherwise healthy people. Diagnostic imaging techniques are help discriminating between benign and malignant nodules, while fine needle aspiration is still a gold standard. Shear wave elastography, a recent imaging technique, holds the promise to become reliable diagnostic tools and is currently used in combination with ultrasound. We here report data obtained in a series of 52 thyroid nodules analysed by means of elastography, as well as conventional and Doppler ultrasound. We found no differences in age, nodule and thyroid volume, length, width, thickness and maximum diameter between benign and malignant lesions. Several sonographic patterns are considered to be predictive of malignancy, out of which we only found the intranodular blood flow to be statistically significant. By the means of shear wave elastography we have first assessed tissue elasticities, which are shown in a range of colours, depending on tissue elasticity/stiffness. Then, we have measured and recorded four parameters automatically displayed by the system, namely SWE-mean, SWE-max, SWE-SD and SWE-ratio. Data analysis showed all these quantitative parameters had good sensitivity, specificity, positive predictive value, negative predictive value and area under the curve, as calculated by the ROC curve. As with these parameters, the cut-off points were lower than in literature, still able to indicate reliable diagnoses, which were confirmed by histopathological exam. Our conclusion is that shear wave elastography has great potential for reliably and accurately diagnosing thyroid malignancies.

Shear wave elastography of thyroid nodules for the prediction of malignancy in a large scale study

2015 ◽  
Vol 84 (3) ◽  
pp. 407-412 ◽  
Author(s):  
Ah Young Park ◽  
Eun Ju Son ◽  
Kyunghwa Han ◽  
Ji Hyun Youk ◽  
Jeong-Ah Kim ◽  
...  
Keyword(s):  
Shear Wave ◽  
Large Scale ◽  
Thyroid Nodules ◽  
Shear Wave Elastography ◽  
Large Scale Study

scholarly journals Accuracy of shear wave elastography in characterization of thyroid nodules in children and adolescents

2021 ◽  
Vol 12 (1) ◽  
Author(s):  
Mohammed Hazem ◽  
Ossama M. Zakaria ◽  
Mohamed Yasser Ibrahim Daoud ◽  
Ibrahim Khalid Al Jabr ◽  
Abdulwahab A. AlYahya ◽  
...  
Keyword(s):  
Children And Adolescents ◽  
Shear Wave ◽  
Diagnostic Performance ◽  
Thyroid Nodules ◽  
Shear Wave Elastography ◽  
Invasive Technique ◽  
Predictive Values ◽  
Patients Âgés ◽  
Non Invasive

Abstract Background Thyroid nodules are an important health problem in children and adolescents. They possess a higher risk of malignancy in comparison to adults. This fact forms a great dilemma for clinicians. The aim of this study was to evaluate the reliability of shear wave elastography (SWE) as a non-invasive technique in the characterization of thyroid nodules in children and adolescents. Methods This prospective study included 56 patients with thyroid nodules. All the patients underwent clinical assessment, laboratory investigations, ultrasound, and Doppler examination, followed by an SWE assessment. Statistical analysis was performed and the best cut-off value to differentiate benign from malignant nodules was determined using the ROC curve and AUC. Results Seventy-two nodules were detected in the examined patients (ages ranged from 11 to 19 years, with mean age of 14.89 ± 2.3 years). Fifty-eight nodules (80.6%) were benign, and fourteen nodules (19.4%) were malignant (histopathologically proved). Highly suspicious criteria for prediction of malignancy by ultrasound and Doppler were hypoechoic echopattern, internal or internal and peripheral vascularity, microcalcifications, taller-than-wide dimensions, irregular outlines, and absence of halo (p < 0.05). The diagnostic performance for their summation was 70.69% sensitivity, 82.8% specificity, 80.45% accuracy, a 63.79% positive predictive value (PPV), and 87.9% negative predictive values (NPV). Regarding SWE, our results showed that 42.2 kPa was the best cut-off value, with AUC = 0.921 to differentiate malignant from benign nodules; the diagnostic performance was 85.71% sensitivity, 94.83% specificity, 93.06% accuracy, 76.9% PPV, and 93.2% NPV. Conclusion Shear wave elastography is a non-invasive technique that can assist in the diagnosis of malignant thyroid nodules among children and adolescents.

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