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Diagnosis of High-Suspicion Thyroid Nodules Using Elastography

By: Sarah Campen, PharmD
Posted: Wednesday, June 24, 2020

Elastography—an imaging modality that reflects stiffness in tissue typically related to malignant lesions—appears to be an effective tool for accurately diagnosing high-suspicion thyroid nodules when combined with the elasticity score, according to a multicenter Chinese study published in BMC Endocrine Disorders. These multicenter findings are based on the 2015 [American Thyroid Association] guidelines, especially in nodules ≥ 1 cm,” according to Hairu Li, MD, of the Second Affiliated Hospital of Harbin Medical University, China, and colleagues.

The researchers evaluated 1,445 thyroid nodules with high-suspicion characteristics using conventional ultrasound and ultrasound strain elastography, identifying 834 malignant and 611 benign lesions. The sensitivity, specificity, and accuracy of the elasticity score were 92.4%, 60.7%, and 79.0%, respectively, and those of the strain ratio were 81.1%, 50.1%, 68.9%, respectively. However, when the Kwak’s Thyroid Imaging Reporting and Data System (TI-RADS) —the mainstream classification of malignant degree—was combined with the elasticity score, the sensitivity and negative predictive values (97.1% and 91.9%, respectively) were significantly increased compared with TI-RADS alone.

Dr. Hairu and colleagues identified several independent predictors of malignant thyroid nodules, including microcalcifications, taller than wide, irregular margins, extrathyroidal extension, and the elasticity score. Additionally, the diagnostic efficacy of elastography with the elasticity score was significantly better for nodules ≥ 1 cm compared with those < 1 cm.

Disclosure: The study authors reported no conflicts of interest.

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