Ah Young Park1, Eun Ju Son1, Kyunghwa Han2, Ji Hyun Youk1, Jeong-Ah Kim3, Cheong Soo Park4. 1. Department of Radiology, Yonsei University College of Medicine, Gangnam Severance Hospital, Seoul, Republic of Korea. 2. Biostatistics Collaboration Unit, Gangnam Medical Research Center, Yonsei University College of Medicine, Gangnam Severance Hospital, Seoul, Republic of Korea. 3. Department of Radiology, Yonsei University College of Medicine, Gangnam Severance Hospital, Seoul, Republic of Korea. Electronic address: chrismd@hanmail.net. 4. Department of Surgery, Yonsei University College of Medicine, Gangnam Severance Hospital, Seoul, Republic of Korea.
Abstract
OBJECTIVES: The purpose of this study is to validate the usefulness of shear wave elastography (SWE) in predicting thyroid malignancy with a large-scale quantitative SWE data. METHODS: This restrospective study included 476 thyroid nodules in 453 patients who underwent gray-scale US and SWE before US-guided fine-needle aspiration biopsy (US-FNA) or surgical excision were included. Gray-scale findings and SWE elasticity indices (EIs) were retrospectively reviewed and compared between benign and malignant thyroid nodules. The optimal cut-off values of EIs for predicting malignancy were determined. The diagnostic performances of gray-scale US and SWE for predicting malignancy were analyzed. The diagnostic performance was compared between the gray-scale US findings only and the combined use of gray-scale US findings with SWEs. RESULTS: All EIs of malignant thyroid nodules were significantly higher than those of benign nodules (p≤.001). The optimal cut-off value of each EI for predicting malignancy was 85.2kPa of Emean, 94.0kPa of Emax, 54.0kPa of Emin. Emean (OR 3.071, p=.005) and Emax (OR 3.015, p=.003) were the independent predictors of thyroid malignancy. Combined use of gray-scale US findings and each EI showed elevated sensitivity (95.0-95.5% vs 92.9%, p≤.005) and AUC (0.820-0.834 vs 0.769, p≤.005) for predicting malignancy, compared with the use of only gray-scale US findings. CONCLUSIONS: Quantitative parameters of SWE were the independent predictors of thyroid malignancy and SWE evaluation combined with gray-scale US was adjunctive to the diagnostic performance of gray-scale US for predicting thyroid malignancy.
OBJECTIVES: The purpose of this study is to validate the usefulness of shear wave elastography (SWE) in predicting thyroid malignancy with a large-scale quantitative SWE data. METHODS: This restrospective study included 476 thyroid nodules in 453 patients who underwent gray-scale US and SWE before US-guided fine-needle aspiration biopsy (US-FNA) or surgical excision were included. Gray-scale findings and SWE elasticity indices (EIs) were retrospectively reviewed and compared between benign and malignant thyroid nodules. The optimal cut-off values of EIs for predicting malignancy were determined. The diagnostic performances of gray-scale US and SWE for predicting malignancy were analyzed. The diagnostic performance was compared between the gray-scale US findings only and the combined use of gray-scale US findings with SWEs. RESULTS: All EIs of malignant thyroid nodules were significantly higher than those of benign nodules (p≤.001). The optimal cut-off value of each EI for predicting malignancy was 85.2kPa of Emean, 94.0kPa of Emax, 54.0kPa of Emin. Emean (OR 3.071, p=.005) and Emax (OR 3.015, p=.003) were the independent predictors of thyroid malignancy. Combined use of gray-scale US findings and each EI showed elevated sensitivity (95.0-95.5% vs 92.9%, p≤.005) and AUC (0.820-0.834 vs 0.769, p≤.005) for predicting malignancy, compared with the use of only gray-scale US findings. CONCLUSIONS: Quantitative parameters of SWE were the independent predictors of thyroid malignancy and SWE evaluation combined with gray-scale US was adjunctive to the diagnostic performance of gray-scale US for predicting thyroid malignancy.
Authors: Katarzyna Dobruch-Sobczak; Anna Gumińska; Elwira Bakuła-Zalewska; Krzysztof Mlosek; Rafał Z Słapa; Paweł Wareluk; Agnieszka Krauze; Agnieszka Ziemiecka; Bartosz Migda; Wiesław Jakubowski; Marek Dedecjus Journal: J Ultrason Date: 2015-12-28