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Updated: Jul 5, 2026
Substernal Thyroid Biopsy Using Endobronchial Ultrasound-guided Transbronchial Needle Aspiration
Published on: November 10, 2014
Shear wave elastography combined with fine-needle aspiration biopsy in the diagnosis of China Thyroid Imaging
Ren-Yan Xu1, Wen-Fang Deng2, Zhe Chen3
1Health Management Center, Affiliated Hospital of Yangzhou University, Yangzhou University, Yangzhou, China.
Background:
Shear wave elastography (SWE) and fine-needle aspiration biopsy (FNAB) are both effective methods for diagnosing thyroid nodules. This study aimed to evaluate the efficiency of SWE combined with FNAB for the diagnosis of China Thyroid Imaging Reporting and Data System (C-TIRADS) category 4 thyroid nodules.
Methods:
The FNAB results and images from conventional ultrasound and SWE of 209 C-TIRADS category 4 thyroid nodules that were confirmed by postoperative pathology from July 2021 to July 2024 were retrospectively analyzed. The diagnostic efficiency of SWE, FNAB, and their combination were assess and compared.
Results:
The receiver operating characteristic (ROC) curve showed the best cutoff value for the SWE maximum elastic modulus of thyroid nodules was 42.65 kPa, yielding an area under the ROC curve (AUC) of 0.823 [95% confidence interval (CI): 0.765-0.880]; meanwhile, the sensitivity, specificity, accuracy were 75.2% (115/153), 78.6% (44/56), and 76.1% (159/209), respectively. FNAB identified 42 benign nodules, 59 indeterminate ones (Bethesda categories III, IV, and V), and 108 malignant ones; meanwhile, the diagnostic sensitivity, specificity, accuracy were 70.6% (108/153), 71.4% (40/56), and 70.8% (148/209), respectively. After SWE was combined with FNAB, 68 and 141 nodules were identified as negative and positive, respectively, and the sensitivity, specificity, accuracy were 92.2% (141/153), 100% (56/56), and 94.3% (197/209), respectively, representing a significant improvement in all three metrics (all P values <0.001).
Conclusions:
SWE and FNAB had reliable diagnostic efficiency for C-TIRADS category 4 thyroid nodules, and their combination had greater sensitivity, specificity, and accuracy, thus supporting their clinical value.
