Ultrasound elastography in thyroid disease

Thyroid elastography has become, lately, one of the main focuses in thyroid imaging. With more than one hundred papers published on this subject, the core of accumulated knowledge justifies the need for a comprehensive review on the topic. The paper presents the various elastographic techniques used for thyroid assessment. Both strain and shear wave elastography, with all their variants, are discussed. Thereafter the paper proceeds to a detailed description of the technical peculiarities, diagnostic value, limitations and pitfalls for each technique. Although the main accent is placed on thyroid nodules, the applications of elastography in other thyroid disease, diffuse or focal, are also presented. The results of the available metaanalyses are reviewed and the proven value of the technique is highlighted. Still unanswered questions and directions for future research are emphasized, whenever appropriate.