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Strain Elastography: A Non-Invasive Modality for Extrathyroidal Extension Assessment in Papillary Thyroid Cancer.

Huahui Liu1, Shuang Liang1, Shiwen Zhang2

  • 1Department of Medical Ultrasonics, The Eighth Affiliated Hospital of Sun Yat-Sen University, Shenzhen, Guangdong Province, China.

Journal of Clinical Ultrasound : JCU
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Summary

Strain elastography (SE) offers a more accurate, noninvasive method for assessing extrathyroidal extension (ETE) in papillary thyroid cancer (PTC) compared to ultrasound. This advanced technique shows higher consistency and diagnostic performance, aiding in better patient management.

Keywords:
continuityextrathyroidal extensionpapillary thyroid cancerstrain elastographyultrasound

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Area of Science:

  • Radiology
  • Oncology
  • Medical Imaging

Background:

  • Papillary thyroid cancer (PTC) is a common endocrine malignancy.
  • Accurate assessment of extrathyroidal extension (ETE) is crucial for treatment planning and prognosis in PTC.
  • Conventional ultrasound (US) has limitations in precisely evaluating ETE.

Purpose of the Study:

  • To evaluate the diagnostic value of strain elastography (SE) in assessing ETE in PTC.
  • To compare the performance of SE with conventional US in detecting ETE.
  • To identify factors influencing the diagnostic accuracy of SE for ETE.

Main Methods:

  • A retrospective study included 277 PTC nodules from 245 patients.
  • Strain elastography (SE) and conventional ultrasound (US) were used to assess ETE.
  • Pathology results served as the gold standard for comparison.

Main Results:

  • SE showed significantly higher consistency with pathology than US (Kappa: 0.735 vs. 0.562, p < 0.001).
  • SE demonstrated superior specificity (91.4% vs. 74.1%) and accuracy (87.7% vs. 78.3%) in diagnosing ETE (p < 0.001).
  • The area under the curve for SE was significantly higher than for US (0.865 vs. 0.798, p = 0.006).

Conclusions:

  • Strain elastography is a valuable, noninvasive tool for assessing ETE in PTC.
  • SE offers improved diagnostic performance over conventional US for ETE detection.
  • Factors such as patient age and nodule calcification may impact SE's effectiveness.