Two-dimensional shear wave elastography as promising diagnostic tool for predicting malignant thyroid nodules: a...

Area of Science:

• Radiology
• Medical Imaging
• Oncology

Background:

• Thyroid nodules are common, and distinguishing between benign and malignant types is crucial for patient management.
• Conventional ultrasound has limitations in accurately characterizing thyroid nodules.
• Elastography techniques, including two-dimensional shear wave elastography (2D-SWE), offer quantitative assessments of tissue stiffness.

Purpose of the Study:

• To evaluate the diagnostic performance of 2D-SWE in differentiating malignant from benign thyroid nodules.
• To assess the accuracy of 2D-SWE measurements in various nodule sizes.

Main Methods:

• A prospective study included 331 focal thyroid nodules from 271 patients undergoing fine-needle aspiration or surgery.
• Conventional ultrasound was followed by 2D-SWE examinations to obtain stiffness measurements.
• 2D-SWE measurements were correlated with final histopathological results.

Main Results:

• Pathology confirmed 230 benign and 101 malignant nodules.
• Areas under the receiver operating characteristic curve (AUC) for various 2D-SWE metrics ranged from 0.673 to 0.808.
• A cut-off value of 39.3 kPa demonstrated 66.3% sensitivity and 84.4% specificity for malignancy detection. Diagnostic performance was highest for nodules 11-30 mm (AUC=0.883) and lower for nodules ≤10 mm (AUC=0.730).

Conclusions:

• 2D-SWE is a valuable tool for improving the discrimination of malignant thyroid nodules.
• The diagnostic performance of 2D-SWE is less satisfactory for small thyroid nodules (≤10 mm).