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Related Experiment Video

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Application of Ultrasound and Shear Wave Elastography Imaging in a Rat Model of NAFLD/NASH

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Variability in Stiffness Assessment in a Thyroid Nodule Using Shear Wave Imaging.

Robert Brezak¹, Dan Hippe, Jeff Thiel

¹Department of Radiology, Body Imaging Section, University of Washington, Seattle, WA.

Ultrasound Quarterly

|November 21, 2015

Summary

This study found good agreement in thyroid nodule stiffness measurements using shear wave elastography. However, softer nodules showed variability, highlighting the need for standardized techniques in elastography analysis.

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Area of Science:

Medical Imaging
Diagnostic Ultrasound
Elastography

Background:

Thyroid nodules are common, and elastography is an emerging tool for their assessment.
Shear wave elastography (SWE) provides quantitative stiffness measurements.
Variability in SWE measurements can impact diagnostic accuracy.

Purpose of the Study:

To evaluate the consistency of measurements made by the same reader (intrareader) and by different readers (interreader) when placing regions of interest on thyroid nodule elastograms.
To assess variability in quantitative stiffness measurements (mean and maximum kPa) derived from these regions of interest.

Main Methods:

Sixty thyroid nodules from 38 patients were analyzed using SWE.
Two independent readers assessed nodules qualitatively and quantitatively, placing a 3-mm region of interest on the stiffest area.
Intrareader and interreader agreement for categorical (presence/number of stiff regions) and continuous (mean/max stiffness) data were calculated using Cohen κ and concordance correlation coefficient (CCC), respectively.

Main Results:

Good intrareader and interreader agreement was observed for qualitative assessment of stiff regions (κ = 0.74-0.81).
Excellent agreement was found for quantitative stiffness measurements: mean kPa (CCC = 0.97/0.93) and max kPa (CCC = 0.97/0.93).
The coefficient of variation for mean and max stiffness was 13-21% for intrareader and interreader comparisons.

Conclusions:

While overall agreement is good, variability in stiffness measurement can occur, particularly in softer nodules, due to limitations in color elastogram visualization.
Standardization of the region of interest placement technique is crucial for reproducible and comparable results in shear wave elastography studies of thyroid nodules.