Effect of ultrasound-elastography in diagnosing malignant thyroid nodules: a single-center experience

Abstract

Background Thyroid disease has a common occurrence, especially in iodine-deficient areas. Thyroid nodules have been reported in as many as 50% of the population, on autopsy. They may be discovered in up to 41% of the patients on ultrasonography (US). Aim The aim of this study is to introduce the value of US-elastography in the diagnosis of thyroid nodules for reducing the number of unnecessary thyroidectomies, which add burden to the patient and community, and consequently, the complications of this surgery will be reduced. Patients and methods This prospective cohort study was conducted at El Demerdash, Ain Shams University Hospital, on 50 patients with the diagnosis of multinodular goiter, who were treated by total thyroidectomy between November 2016 and November 2018, with minimum follow-up of 1 month postoperatively. All patients who accepted to participate in our study were consented for participation after ethical committee approval. Results Using the US-elastography, we noted that the scores 3–4 were seen in eight (16%) of 50 patients, where six (12%) of them were malignant and two (4%) were benign. However, the scores 1 and 2 were detected in 42 (100%) patients, and all were benign. The two false-positive patients with scores 3–4 diagnosed with the elastography scoring system could be owing to calcifications and fibrotic changes, rendering the nodules harder. On the contrary, no false-negative results were found as score 1 and 2 by the elastography scoring system. Conclusion Conclusively, in the future, fine-needle aspiration cytology may not be used for the diagnosis of malignancy in patients presented with multinodular goiters who were diagnosed as being suspicious of malignancy by sono-elastography.