Virtual Touch Tissue Imaging and Quantification in the Evaluation of Thyroid Nodules

Area of Science:

• Medical imaging
• Diagnostic ultrasound
• Elastography

Background:

• Thyroid nodules are common, and accurate malignancy prediction is crucial for patient management.
• Conventional sonography has limitations in differentiating benign from malignant thyroid nodules.
• Elastography techniques offer potential for improved diagnostic accuracy.

Purpose of the Study:

• To evaluate the diagnostic performance of 2-dimensional shear wave elastography (Virtual Touch tissue imaging and quantification, VTIQ) for predicting thyroid malignancy.
• To compare the efficacy of VTIQ-derived shear wave speed (SWS) indices against conventional sonographic features.

Main Methods:

• 302 thyroid nodules were assessed using conventional sonography and VTIQ prior to fine-needle aspiration or surgery.
• Shear wave speed indices (SWSmin, SWSmax, SWSmean) were measured using VTIQ.
• Diagnostic performance was evaluated against histopathologic/cytologic results.

Main Results:

• All VTIQ SWS indices were significantly lower in benign nodules compared to malignant ones (P < .001).
• VTIQ SWS indices demonstrated superior diagnostic performance over conventional sonographic features for malignancy prediction (P < .05).
• VTIQ achieved 84.6% sensitivity and 94.3% negative predictive value for differentiating nodules using a SWSmean cutoff of 2.60 m/s.
• Diagnostic performance was better for nodules larger than 10 mm compared to smaller ones (AUCs ranging from 0.862-0.891 vs 0.717).
• Excellent inter- and intraoperator reproducibility was confirmed (ICC > 0.80).

Conclusions:

• Virtual Touch tissue imaging and quantification (VTIQ) is a valuable tool for predicting thyroid malignancy.
• VTIQ demonstrates high diagnostic accuracy and excellent reproducibility.
• This technique can aid in differentiating benign from malignant thyroid nodules, potentially improving diagnostic workflows.