Differential diagnosis of small single solid thyroid nodules using real-time ultrasound elastography

Area of Science:

• Medical Imaging
• Oncology
• Endocrinology

Background:

• Thyroid nodules < 10 mm with indeterminate ultrasound findings pose diagnostic challenges.
• Accurate differentiation between benign and malignant microcarcinomas is crucial for appropriate patient management.

Purpose of the Study:

• To evaluate the diagnostic performance of real-time ultrasound elastography (USE) for single solid thyroid nodules < 10 mm.
• To compare USE results with histopathological findings in patients with indeterminate conventional ultrasound results.

Main Methods:

• Prospective study of 51 patients with single solid thyroid nodules (< 10 mm) and indeterminate conventional ultrasound results.
• Real-time ultrasound elastography (USE) was performed, and results were correlated with histopathology.
• Diagnostic accuracy, sensitivity, and specificity of USE were calculated.

Main Results:

• The study included 19 follicular adenomas and 32 papillary thyroid microcarcinomas (PTMCs).
• A real-time USE score of 4-5 correctly identified PTMCs with 90.63% sensitivity, 89.47% specificity, and 90.20% accuracy.
• Positive and negative predictive values were 93.55% and 85.00%, respectively.

Conclusions:

• Real-time ultrasound elastography (USE) is a valuable tool for the differential diagnosis of small thyroid nodules with indeterminate conventional ultrasound features.
• USE can assist in distinguishing papillary thyroid microcarcinomas (PTMCs) from benign follicular adenomas, potentially reducing unnecessary surgeries.