Can real-time ultrasound elastography using the color score and strain ratio differentiate between benign and malignant solitary thyroid nodules?

Abstract Purpose To evaluate the diagnostic performance of strain ratio elastography (SRE) and shear wave elastography (SWE) alone and in combination with Thyroid Imaging Reporting and Data System (TIRADS) classification parameters to improve differentiation between benign and malignant thyroid nodules. Materials and Methods In this prospective study benign (n = 191) and malignant (n = 52) thyroid nodules were examined with high-resolution ultrasound (US) features using the TIRADS lexicon and SRE semiquantitative and SWE quantitative findings using histology or cytology as the gold standard with a 12-month follow-up. Sensitivity (Se), specificity (Sp) and the area under the ROC curve (AUROC) were used to evaluate the diagnostic performance of each feature and combinations of the methods. Results TIRADS score showed a sensitivity of 59.6 %, a specificity of 83.8 % with an AUROC of 0.717, a PPV of 50.0 % and an NPV of 88.4 %. SRE yielded the highest performance with a sensitivity of 82.7 %, a specificity of 92.7 % with AUROC of 0.877, a PPV 75.4 % and an NPV of 95.2 %. SWE (kPa) had a sensitivity and specificity of 67.3 % and 82.7 %, respectively, with an AUROC of 0.750, a PPV of 51.5 % and an NPV of 90.3 %. Differences were significant for SRE only but not for SWE. Conclusion Ultrasound elastography may improve thyroid nodule discrimination. In particular, SRE has a better performance than TIRADS classification, while their combination improves sensitivity.

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Real time endoscopic ultrasound elastography and strain ratio in the diagnosis of solid pancreatic lesions

World Journal of Gastroenterology ◽

10.3748/wjg.v23.i32.5962 ◽

2017 ◽

Vol 23 (32) ◽

pp. 5962 ◽

Cited By ~ 5

Author(s):

Hussein Okasha ◽

Shaimaa Elkholy ◽

Ramy El-Sayed ◽

Mohamed-Naguib Wifi ◽

Mohamed El-Nady ◽

...

Keyword(s):

Real Time ◽

Endoscopic Ultrasound ◽

Strain Ratio ◽

Ultrasound Elastography

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Real-time ultrasound elastography of the Achilles tendon in patients with cerebral palsy: is there a correlation between strain ratio and biomechanical indicators?

Journal of Medical Ultrasonics ◽

10.1007/s10396-017-0800-y ◽

2017 ◽

Vol 45 (1) ◽

pp. 143-148 ◽

Cited By ~ 3

Author(s):

Mehmet Öztürk ◽

Bahattin Sayinbatur

Keyword(s):

Cerebral Palsy ◽

Achilles Tendon ◽

Real Time ◽

Strain Ratio ◽

Ultrasound Elastography

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Cystic change in thyroid nodules: A confounding factor for real-time qualitative thyroid ultrasound elastography

Clinical Radiology ◽

10.1016/j.crad.2011.03.011 ◽

2011 ◽

Vol 66 (9) ◽

pp. 799-807 ◽

Cited By ~ 54

Author(s):

K.S.S. Bhatia ◽

D.P. Rasalkar ◽

Y.P. Lee ◽

K.T. Wong ◽

A.D. King ◽

...

Keyword(s):

Real Time ◽

Thyroid Nodules ◽

Confounding Factor ◽

Ultrasound Elastography ◽

Thyroid Ultrasound ◽

Cystic Change

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Diagnostic accuracy of B-mode ultrasound, ultrasound elastography and diffusion weighted MRI in differentiation of thyroid nodules (prospective study)

Egyptian Journal of Radiology and Nuclear Medicine ◽

10.1186/s43055-021-00640-9 ◽

2021 ◽

Vol 52 (1) ◽

Author(s):

Mahmoud Abdel Latif ◽

Magdy Mohamed El Rakhawy ◽

Mohamed Fathy Saleh

Keyword(s):

Thyroid Nodules ◽

Strain Ratio ◽

Ultrasound Elastography ◽

Thyroid Ultrasound ◽

Diffusion Weighted Mri ◽

Adc Value ◽

Diffusion Weighted ◽

And Diffusion ◽

Benign Thyroid Nodules ◽

Benign Thyroid

Abstract Background The incidence of the thyroid nodules and its detection is increasing rapidly. The most precise method for diagnosis of the nodules of the thyroid is FNAC. But, about 10–20% of specimens of FNAC are indeterminate and non-diagnostic. Therefore, there is a demand for another diagnostic method for evaluating thyroid nodules. Thyroid ultrasound elastography may improve the ability to differentiate malignant from benign thyroid nodules. Few articles were published about the results of DW MRI in thyroid nodules, with its results confirmed that malignant nodules have lower mean ADC values than benign nodules. This study aims to investigate and compare the accuracy of B-mode ultrasound, ultrasound elastography and diffusion-weighted MRI in characterization of the nodules of the thyroid. Results The study included 56 patients with thyroid nodules (36 benign and 20 malignant). Thyroid ultrasound, ultrasound elastography and DWI were done for all patients. Ultrasound-guided FNA Cytological examination (as the gold standard) was done for 48 patients and surgical histopathology was done to 8 patients with non-diagnostic FNAC. The results showed: TIRADS score had sensitivity 90%, specificity 77.8% and accuracy of 82.14%. The elastography score had sensitivity 80%, specificity 88.9% and accuracy 85.7%. The use of the strain ratio had 80% sensitivity, 94.4% specificity and 89.3% accuracy. DWI and ADC value had 100% sensitivity and 94.4% specificity and the accuracy was 96.4% for differentiating malignant from benign thyroid nodules. Multi-parametric analysis by TIRADS and ADC had 100% accuracy. Conclusion Ultrasound elastography add valuable data over ultrasound TIRADS. But, diffusion weighted MRI and ADC value has more accuracy in differentiating malignant from benign thyroid nodules. The best performance was achieved by the combination of ACR-TIRADS and ADC value.

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