A comparative analysis of strain and shear wave elastography in differentiating thyroid nodules

Area of Science:

• Radiology
• Medical Imaging
• Oncology

Background:

• Conventional ultrasonography has limited accuracy for diagnosing thyroid malignancy.
• Strain Elastography (SE) is sensitive but operator-dependent.
• Shear Wave Elastography (SWE) offers quantitative, reproducible stiffness measurements.

Purpose of the Study:

• To directly compare the diagnostic accuracy of SE and SWE in differentiating benign from malignant thyroid nodules.
• To evaluate the performance of SE and SWE against cytological or histological results.

Main Methods:

• Prospective evaluation of 281 patients with thyroid nodules.
• Nodules classified using ACR-TIRADS criteria; 88 underwent fine-needle aspiration (FNA).
• Both SE and SWE were used to quantify nodule stiffness; logistic regression and ROC analyses were performed.

Main Results:

• Strong correlation observed between SE and SWE (Spearman's r = 0.363, p < 0.001).
• Comparable diagnostic performance: SE (sensitivity 80%, specificity 93%) and SWE (sensitivity 80%, specificity 96%).
• No significant difference in diagnostic accuracy between SE and SWE (p = 0.552); combined AUC was 0.906.

Conclusions:

• SE and SWE exhibit comparable diagnostic accuracy for thyroid nodules, significantly exceeding conventional ultrasound.
• Choice between SE and SWE can be based on resource availability and expertise.
• Both methods are valuable tools, especially when integrated with ACR-TIRADS criteria for thyroid nodule assessment.