Thyroid Nodules and Shear Wave Elastography: A New Tool in Thyroid Cancer Detection

Area of Science:

• Medical Imaging
• Diagnostic Ultrasound
• Elastography

Background:

• Thyroid nodules (TNs) are common, and distinguishing benign from malignant ones is crucial for appropriate management.
• Fine-needle aspiration biopsy (FNAB) is the standard diagnostic tool, but can yield indeterminate results.
• Non-invasive methods are sought to improve diagnostic accuracy and reduce unnecessary procedures.

Purpose of the Study:

• To evaluate the performance of Virtual Touch Imaging Quantification (VTIQ), a shear wave elastography technique, in distinguishing benign from malignant thyroid nodules.
• To compare the diagnostic efficacy of VTIQ-measured shear wave velocity (SWV) with conventional B-mode ultrasound features.
• To determine if TN stiffness measured by VTIQ is an independent predictor of thyroid cancer (TC).

Main Methods:

• Prospective evaluation of 707 TNs in 676 patients.
• Conventional B-mode ultrasound and VTIQ shear wave elastography performed before FNAB.
• Surgical pathology used as the gold standard for malignancy confirmation in 82 malignant TNs.

Main Results:

• A shear wave velocity (SWV) cut-off of 3.54 m/s was identified as optimal for predicting thyroid cancer.
• Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) for malignancy were 79.27%, 71.52%, 26.75%, and 96.34%, respectively.
• VTIQ-derived SWV demonstrated superior diagnostic performance compared to B-mode ultrasound features.

Conclusions:

• Thyroid nodule stiffness measured by VTIQ-generated shear wave elastography is a valuable, independent predictor of thyroid cancer.
• VTIQ offers a non-invasive adjunct to FNAB for improving the diagnosis of malignant thyroid nodules.
• SWV measurement by VTIQ can enhance the differentiation between benign and malignant thyroid lesions.