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Updated: Jan 7, 2026
Author Spotlight: Integrating Ultrasound Imaging with Biochemical Markers for Thyroid Disease Diagnosis
Published on: February 9, 2024
Prospective differentiation of difficult-to-diagnose thyroid nodules using shear wave elastography
Luying Gao1, Xuehua Xi2, Yuxin Jiang1
1Department of Ultrasound, Peking Union Medical College Hospital, State Key Laboratory of Complex Severe and Rare Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
Context:
Thyroid nodules with intermediate- and low-suspicion patterns are difficult to diagnose, based on the 2015 American Thyroid Association (ATA) stratification.
Aims:
We evaluated the performance of shear wave elastography (SWE) as an adjunctive tool to ultrasound (US) in predicting the malignancy of these thyroid nodules.
Settings And Design:
Thyroid nodules (n = 270) collected from January to April 2018 with low or intermediate suspicion for malignancy were evaluated.
Methods, Materials, And Statistical Analyses:
The maximum SWE elasticity values (Emax) for the nodules were examined and subsequently confirmed by pathology. SWE and ATA guidelines, as well as a combination of the two, were applied.
Results:
Combined with SWE, the diagnostic accuracy of the ATA categories was superior to the ATA categories alone (area under the curve, AUC 0.81 vs. 0.72, P < 0.05). Based on the ATA categories, the percentages of malignancy in the nodules with low and intermediate suspicion for malignancy were 21.1% (12/57) and 54.2% (13/24), respectively. After adjustments for the use of SWE, the nodules were restratified as very low, low, intermediate, and high suspicion of malignancy. The percentages of malignancy for the very low, low, intermediate, and high suspicion nodules were 0 (0/26), 27.3% (3/11), 37.8% (12/31), and 76.9% (10/13), respectively.
Conclusion:
SWE may be used to differentiate malignant and benign nodules in addition to the ATA pattern. Combined with the ATA pattern, SWE supplemented US for predicting nodules with low and intermediate suspicion of malignancy.
