J Korean Soc Radiol.  2016 Feb;74(2):96-104. 10.3348/jksr.2016.74.2.96.

The Diagnostic Performance of Acoustic Radiation Force Impulse Elasticity Imaging to Differentiate Malignant from Benign Thyroid Nodules: Comparison with Conventional B-Mode Sonographic Findings

• Jung WS
• An YY
• Ihn YK
• Park YH

• KMID: 2152601
• DOI: http://doi.org/10.3348/jksr.2016.74.2.96

Abstract

PURPOSE
The purpose of this study was to evaluate the diagnostic performance of acoustic radiation force impulse (ARFI) elasticity imaging.
MATERIALS AND METHODS
One hundred and twenty-seven thyroid nodules were examined by both ARFI elastography and B-mode sonography. Virtual Touch tissue quantification (VTQ) values of the thyroid nodules were measured. Scoring of B-mode sonographic findings of each thyroid nodules was performed. The sums of these VTQ and the B-mode scores were determined. The comparative diagnostic performances of the VTQ value, the B-mode score, and the combined score were analyzed.
RESULTS
The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of each scoring mode were: B-mode score, 84%, 85%, 66%, 94%, and 85%; VTQ, 75%, 91%, 73%, 92%, and 86%; and combined score, 88%, 87%, 70%, 95%, and 88%. The areas under the curves for B-mode, VTQ, and combined score were 0.895, 0.837, and 0.912, respectively. Pairwise comparisons of receiver-operating characteristic curves showed no statistical differences between B-mode and VTQ, and B-mode and combined score. Combined score showed better diagnostic performance than VTQ value (p = 0.0023).
CONCLUSION
ARFI VTQ value is a good diagnostic modality for differentiating malignant thyroid nodules from benign nodules. However, ARFI evaluation is not superior to B-mode sonographic evaluation, but only has a better diagnostic performance when combined with B-mode sonographic findings.

MeSH Terms

Acoustics*
Elasticity Imaging Techniques
Elasticity*
Sensitivity and Specificity
Thyroid Gland*
Thyroid Nodule*
Ultrasonography*

Figure

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  Fig. 1 Solid, marked hypoechoic nodule with calcification shows high VTQ score (4.22 m/s). This nodule was confirmed as papillary thyroid carcinoma. VTQ = Virtual Touch tissue quantification

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  Fig. 2 Predominantly solid, isoechoic nodule shows low VTQ score (1.20 m/s) in ARFI evaluation. This nodule was confirmed as benign nodular hyperplasia. ARFI = acoustic radiation force impulse, VTQ = Virtual Touch tissue quantification

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  Fig. 3 Receiver operating characteristic curves for B-mode evaluation, VTQ value and combined evaluation. Area under the curve for combined evaluation (0.912) is higher than that for B-mode (0.895) or VTQ value (0.837). VTQ = Virtual Touch tissue quantification

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  Fig. 4 Solid, heterogeneous isoechoic nodule shows relatively low VTQ value (2.03 m/s). This nodule was confirmed as follicular carcinoma. VTQ = Virtual Touch tissue quantification

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  Fig. 5 Hypoechoic solid nodule with macrocalcification shows high VTQ value (4.71 m/s) in ARFI evaluation. This nodule was confirmed as benign nodule with calcific degeneration. ARFI = acoustic radiation force impulse, VTQ = Virtual Touch tissue quantification

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