Diagnostic value of shear wave elastography towards TI-RADS fourth classification thyroid nodules

Abstract

Objective To evaluate the diagnostic value of shear wave elastography (SWE) towards thyroid nodules of the fourth classification in the thyroid imaging reporting and data system (TI-RADS). Methods A total of 271 TI-RADS fourth classification (TR4) thyroid nodules in 178 patients admitted to the Affiliated Hospital of Jining Medical University from October 2017 to November 2018 were examined by SWE. The values of SWE parameters (including Emax, Emean and Emin values) were obtained. The surgical and pathological results were taken as the gold standard to draw the receiver operating characteristic (ROC) curve of subjects and calculate the area under the curve (AUC). Results Among 271 nodules, 76 cases were benign nodules and 195 cases were malignant nodules. The AUC of Emax (0.932) and Emean (0.904) was significantly higher than that of Emin (0.752), with statistically significant difference (P<0.05). The optimal critical value of Emax was 38.6 kPa, and optimal critical value of Emean was 27.5 kPa. The sensitivity, specificity, accuracy, positive predictive value and negative predictive value of TI-RADS classification combined with SWE in the diagnosis of benign and malignant TI-RADS TR4 nodules were 96.41%, 90.79%, 94.83%, 96.41% and 90.79%, respectively, which were better than the two single methods. The AUC of the combined diagnosis (0.936) was significantly higher than that of TI-RADS (0.800) and SWE (0.863), and the difference was statistically significant (P<0.01). Conclusions TI-RADS classification combined with SWE could further improve the diagnostic level of TI-RADS TR4 nodules and help to guide the selection of clinical diagnosis and treatment methods. Key words: Shear wave elastography; Thyroid imaging reporting and data system classification; Fine needle aspiration