Korean J Endocr Surg.  2010 Dec;10(4):229-234. 10.16956/kjes.2010.10.4.229.

Ultrasound Elastography in Differential Diagnosis of Benign and Malignant Thyroid Nodules

Affiliations
  • 1Department of Surgery, National Police Hospital, Seoul, Korea. kky57010@hanmail.net

Abstract

PURPOSE
The study evaluated elastography, a technique that allows differentiation between pathological and normal tissue by determination of tissue hardness.
METHODS
From March 2009 to April 2010, 25 consecutive patients with thyroid nodules who were referred for surgical treatment were examined in this prospective study. Thirty nodules in these patients were examined by conventional ultrasound, ultrasound elastography, and fine needle aspiration cytology. Lesions were scored (1~3) according to hardness based on the Ueno classification system. The final diagnosis was based on histopathologic results.
RESULTS
Of the 30 thyroid nodules, four were classified as benign and 26 were malignant. Two of the nodules with an elastography score of 1 were benign and 17 nodules whose elastography score was 3 were malignant. Two benign nodules and nine malignant nodules had an elastography score of 2. Applying an elastography score exceeding 2 as a indicator for malignancy determined that the sensitivity and specificity of the ultrasound elastography was 100.0% and 50.0%, respectively, the positive and negativepredictive values were 92.9% and 100.0%, respectively, and the accuracy of the technique was 93.3%.
CONCLUSION
Ultrasound elastography may be a useful adjunct to ultrasonography in the identification of indeterminate thyroid nodules for which tissue diagnosis is required.

Keyword

Thyroid nodule; Ultrasound elastography; Fine needle aspiration cytology

MeSH Terms

Biopsy, Fine-Needle
Classification
Diagnosis
Diagnosis, Differential*
Elasticity Imaging Techniques*
Hardness
Humans
Prospective Studies
Sensitivity and Specificity
Thyroid Gland*
Thyroid Nodule*
Ultrasonography*

Cited by  1 articles

Using Ultrasound Elastography for Making the Differential Diagnosis of Thyroid Nodules
Jung Hoon Kim M.D., Jae Young Choi M.D., Young Sik Choi M.D., Mi Hee Jung M.D., Kyung Soon Jung M.D.
Korean J Endocr Surg. 2011;11(1):12-17.    doi: 10.16956/kjes.2011.11.1.12.


Reference

1.Tan GH., Gharib H. Thyroid incidentalomas: management approaches to nonpalpable nodules discovered incidentally on thyroid imaging. Ann Intern Med. 1997. 126:226–31.
Article
2.Ross DS. Nonpalpable thyroid nodules–managing an epidemic. J Clin Endocrinol Metab. 2002. 87:1938–40.
Article
3.Siperstein AE., Clark OH. Thyroid diseases: tumors, carcinoma of follicular epithelium, surgical therapy. Braverman LE, Utiger RD, editors. Werner and Ingbar's the Thyroid: A Funda-Mental And Clinical Text. 8th ed.Philadelphia, Pa: Lippincott Williams & Wilkins;2000. p. 898–9.
4.Tan GH., Gharib H., Reading CC. Solitary thyroid nodule. Comparison between palpation and ultrasonography. Arch Intern Med. 1995. 155:2418–23.
Article
5.Baloch ZW., Sack MJ., Yu GH., Livolsi VA., Gupta PK. Fine-needle aspiration of thyroid: an institutional experience. Thyroid. 1998. 8:565–9.
Article
6.Agrawal S. Diagnostic accuracy and role of fine needle aspiration cytology in management of thyroid nodules. J Surg Oncol. 1995. 58:168–72.
Article
7.Takashima S., Fukuda H., Nomura N., Kishimoto H., Kim T., Kobayashi T. Thyroid nodules: re-evaluation with ultrasound. J Clin Ultrasound. 1995. 23:179–84.
Article
8.Lerner RM., Huang SR., Parker KJ. "Sonoelasticity" images derived from ultrasound signals in mechanically vibrated tissues. Ultrasound Med Biol. 1990. 16:231–9.
Article
9.Ophir J., Alam SK., Garra B., Kallel F., Konofagou E., Krouskop T, et al. Elastography: ultrasonic estimation and imaging of the elastic properties of tissues. Proc Inst Mech Eng H. 1999. 213:203–33.
Article
10.Ophir J., Céspedes I., Ponnekanti H., Yazdi Y., Li X. Elastography: a quantitative method for imaging the elasticity of biological tissues. Ultrason Imaging. 1991. 13:111–34.
Article
11.Ophir J., Garra B., Kallel F., Konofagou E., Krouskop T., Righetti R, et al. Elastographic imaging. Ultrasound Med Biol. 2000. 26:S23–9.
Article
12.Itoh A., Ueno E., Tohno E., Kamma H., Takahashi H., Shiina T, et al. Breast disease: clinical application of US elastography for diagnosis. Radiology. 2006. 239:341–50.
Article
13.Tardivon A., El Khoury C., Thibault F., Wyler A., Barreau B., Neuenschwander S. Elastography of the breast: a prospective study of 122 lesions. J Radiol. 2007. 88:657–62.
14.Taylor LS., Rubens DJ., Porter BC., Wu Z., Baggs RB., di Sant'Agnese PA. Prostate cancer: three-dimensional sono-elastography for in vitro detection. Radiology. 2005. 237:981–5.
Article
15.Thomas A., Kümmel S., Gemeinhardt O., Fischer T. Real-time sonoelastography of the cervix: tissue elasticity of the normal and abnormal cervix. Acad Radiol. 2007. 14:193–200.
Article
16.Lyshchik A., Higashi T., Asato R., Tanaka S., Ito J., Mai JJ, et al. Thyroid gland tumor diagnosis at US elastography. Radiology. 2005. 237:202–11.
Article
17.Rago T., Vitti P. Potential value of elastosonography in the diagnosis of malignancy in thyroid nodules. Q J Nucl Med Mol Imaging. 2009. 53:455–64.
18.Rago T., Santini F., Scutari M., Pinchera A., Vitti P. Elastography: new developments in ultrasound for predicting malignancy in thyroid nodules. J Clin Endocrinol Metab. 2007. 92:2917–22.
Article
19.Ueno E., Ito A. Diagnosis of breast cancer by elasticity imaging Eizo Joho Medical. 2004. 36:2–6.
20.Brander A., Viikinkoski P., Nickels J., Kivisaari L. Thyroid gland: US screening in a random adult population. Radiology. 1991. 181:683–7.
Article
21.Ahn SY., Park JJ., Ko ES., Jeon SY., Ahn SK., Kim DW, et al. The diagnostic values of ultrasonography in the papillary thyroid carcinoma. J Clinical Otolaryngol. 2009. 20:55–9.
Article
22.Hegedüs L Clinical practice. The thyroid nodule. N Engl J Med. 2004. 351:1764–71.
23.Tranquart F., Bleuzen A., Pierre-Renoult P., Chabrolle C., Sam Giao M., Lecomte P. Elastosonography of thyroid lesions. J Radiol. 2008. 89:35–9.
24.Asteria C., Giovanardi A., Pizzocaro A., Cozzaglio L., Morabito A., Somalvico F, et al. US-elastography in the differential diagnosis of benign and malignant thyroid nodules. Thyroid. 2008. 18:523–31.
Article
25.Rubaltelli L., Corradin S., Dorigo A., Stabilito M., Tregnaghi A., Borsato S, et al. Differential diagnosis of benign and malignant thyroid nodules at elastosonography. Ultraschall Med. 2009. 30:175–9.
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