Diagnostic utility of real-time ultrasound elastography for prediction of malignancy in solid thyroid nodules

Abstract

Aim of the workTo study the diagnostic utility of real-time ultrasound elastography (USE) in predicting malignancy in thyroid nodules. Materials and methodsForty-five patients with solitary solid thyroid nodules were included in this study. The thyroid nodules were examined by B-mode ultrasound, color flow Doppler ultrasound, and real-time ultrasound elastography (USE). The final diagnosis was obtained from histopathological findings. Tissue stiffness on USE was scored from 1 (low stiffness over the entire nodule) to 6 (high stiffness over the entire nodule and surrounding tissue). ResultsTwenty-eight (62.2%) patients had a final diagnosis of malignancy based on histopathological evidence of malignant thyroid nodules, while 17 (37.8%) were diagnosed as benign nodules. Anteroposterior/transverse (AP/T) diameter more than 1cm, ill-defined margins and spot micro calcifications were the most predictive conventional ultrasound patterns of malignancy. Elasticity score of 4–6 was highly predictive of malignancy (P<0.0001), with a sensitivity of 89.3%, a specificity of 88.2% and an accuracy of 88.9%. ConclusionUltrasound elastography is an accurate non invasive tool for evaluating thyroid nodules. It has more appropriate value in the differential diagnosis of thyroid malignancy and enhances the diagnostic assurance of ultrasonographers.