Real-time shear wave elastography in differential diagnosis of benign and malignant thyroid nodules

Abstract

Objective This study aimed to discuss the performance and impact factors of shear wave elastography (SWE) for differential diagnosis of thyroid nodules (TN). Methods 84 TNs were included in the study. The SWE indices of Emax, Emin and Emean for the region-of-interest were calculated and analyzed. All TNs were divided into subgroups ( 10.0 mm group) according to the size and whether it has calcification (calcification group and non-calcification group). We compared the elasticity indices between subgroups and analyzed the diagnostic performance of SWE with different impact factors. Results There were 40 benign TNs and 44 malignant TNs. The Emean and Emax of malignant TNs were significant higher than those of benign TNs (P=0.000). Both the Emean and Emax of were significant higher in TNs with presence of calcification (P=0.036, P=0.031). The receiver operator characteristic (ROC) curve showed that the diagnostic sensitivity was 94.7% in the >10.0 mm group with Emean >19.6 kPa as the cut-off value, and 92.9% in non-calcification group with Emean >21.1 kPa as the cut-off value. Conclusions The elastic modulus of malignant TNs was significant higher than benign TNs. The presence of calcification may increase the stiffness of TNs. The diagnostic performance of SWE was better in TNs with those sizes >10 mm and TNs with absence of calcification. Key words: Ultrasonography; Elasticity imaging techniques; Thyroid nodule