Korean J Intern Med.  2019 Jul;34(4):850-857. 10.3904/kjim.2016.326.

Utility of shear wave elastography to detect papillary thyroid carcinoma in thyroid nodules: efficacy of the standard deviation elasticity

Affiliations
  • 1Division of Endocrinology and Metabolism, Department of Internal Medicine, Soonchunhyang University Seoul Hospital, Seoul, Korea. mhyoo@schmc.ac.kr
  • 2Department of Pathology, Soonchunhyang University Seoul Hospital, Seoul, Korea.

Abstract

BACKGROUND/AIMS
The aim of this study was to address the role of the elasticity index as a possible predictive marker for detecting papillary thyroid carcinoma (PTC) and quantitatively assess shear wave elastography (SWE) as a tool for differentiating PTC from benign thyroid nodules.
METHODS
One hundred and nineteen patients with thyroid nodules undergoing SWE before ultrasound-guided fine needle aspiration and core needle biopsy were analyzed. The mean (E(Mean)), minimum (E(Min)), maximum (E(Max)), and standard deviation (E(SD)) of SWE elasticity indices were measured.
RESULTS
Among 105 nodules, 14 were PTC and 91 were benign. The E(Mean), E(Min), and E(Max) values were significantly higher in PTCs than benign nodules (E(Mean) 37.4 in PTC vs. 23.7 in benign nodules, p = 0.005; E(Min) 27.9 vs. 17.8, p = 0.034; E(Max) 46.7 vs. 31.5, p < 0.001). The E(Mean), E(Min), and E(Max) were significantly associated with PTC with diagnostic odds ratios varying from 6.74 to 9.91, high specificities (86.4%, 86.4%, and 88.1%, respectively), and positive likelihood ratios (4.21, 3.69, and 4.82, respectively). The E(SD) values were significantly higher in PTC than in benign nodules (6.3 vs. 2.6, p < 0.001). E(SD) had the highest specificity (96.6%) when applied with a cut-off value of 6.5 kPa. It had a positive likelihood ratio of 14.75 and a diagnostic odds ratio of 28.50.
CONCLUSIONS
The shear elasticity index of E(SD), with higher likelihood ratios for PTC, will probably identify nodules that have a high potential for malignancy. It may help to identify and select malignant nodules, while reducing unnecessary fine needle aspiration and core needle biopsies of benign nodules.

Keyword

Elasticity imaging techniques; Shear wave; Thyroid cancer, papillary; Thyroid nodule

MeSH Terms

Biopsy, Fine-Needle
Biopsy, Large-Core Needle
Elasticity Imaging Techniques*
Elasticity*
Humans
Odds Ratio
Sensitivity and Specificity
Thyroid Gland*
Thyroid Neoplasms*
Thyroid Nodule*
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