Ultrasound sensitivity for thyroid malignancy is increased by real-time elastography: a prospective multicenter...

Area of Science:

• Radiology
• Oncology
• Endocrinology

Background:

• Thyroid nodules require biopsy based on clinical and ultrasound (US) findings.
• US detects potentially malignant nodules but cannot definitively rule out cancer in lesions without suspicious features.

Purpose of the Study:

• To evaluate the diagnostic accuracy of real-time elastography (RTE) for thyroid nodules.
• To assess the diagnostic improvement by combining RTE with B-mode US and color flow Doppler (CFD).

Main Methods:

• A prospective multicenter study involving 498 thyroid nodules.
• Nodules were evaluated by US, CFD, and RTE before biopsy or surgery.
• RTE classification used a four-class color scale; patients underwent follow-up or surgery based on cytology.

Main Results:

• RTE classes III-IV demonstrated 81% sensitivity and 62% specificity for malignancy.
• US risk factors showed 85% sensitivity and 91% negative predictive value.
• Combining RTE with US yielded 97% sensitivity and 97% negative predictive value for malignancy.

Conclusions:

• RTE is valuable for detecting malignant thyroid lesions, with sensitivity comparable to US and CFD.
• Integrating RTE with US significantly enhances sensitivity for malignancy detection.
• RTE improves the reliability of selecting nodules that may not require cytology.