Diagnostic Accuracy of Ultrasound Elastography Versus Fine-Needle Aspiration Cytology in Predicting Benign and Malignant Thyroid Nodules in Solitary and Multinodular Thyroid Glands: A Comparative Analysis.

Abstract

Background The diagnosis of thyroid nodules requires accurate techniques; fine-needle aspiration cytology (FNAC) is the gold standard, while ultrasonography elastography has potential but is not well supported by data, particularly when it comes to differentiating benign from malignant nodules in single and multiple noduled glands. Objective This study's main goal was to assess the diagnostic accuracy of ultrasound elastography in predicting benign versus malignant thyroid nodules, both in solitary and multinodular thyroid glands, compared with FNAC. Methodology This prospective observational study evaluated thyroid nodules using ultrasound elastography and FNAC. Patients who were 18 years of age or older and had visible thyroid nodules met the inclusion criteria; those who had undergone thyroid surgery in the past, had cancer, or refused both tests were excluded. Data on demographics, clinical conditions, and imaging were gathered from 360 enrolled patients. Statistical analysis included calculating sensitivity, specificity, and diagnostic accuracy of ultrasound elastography using FNAC as a reference, alongside receiver operating characteristic curve analysis to determine the optimal cutoff for benign versus malignant nodules. Results There were 360 individuals in the trial, 250 of whom had benign thyroid nodules and 110 of whom had malignant ones. When compared to ultrasound elastography, FNAC showed somewhat better sensitivity (92.00%) and specificity (85.33%) for benign nodules. On the other hand, for malignant nodules, FNAC showed better specificity (80.95%) and sensitivity (91.82%) than ultrasonic elastography. In all age categories, FNAC consistently performed better than ultrasound elastography. The total accuracy obtained by ultrasound elastography was 81.94%, but the accuracy obtained by FNAC was higher at 85.47%. Ultrasound elastography's ideal cutoff value was found to be 4.2, with a sensitivity of 87.25% and a specificity of 78.40%. Conclusion Ultrasound elastography shows significant promise as a non-invasive, real-time complementary tool to FNAC for diagnosing thyroid nodules.