Abstract
The elastic properties of tissue have always been of interest in clinical practice. In the past, the identification of structures that were stiffer on physical palpation would raise the suspicion that “there was something wrong”. With the development and advancement of medicine, there proved to be a true correlation in the prediction of malignancy of a lesion: malignant disease tends to stiffen the affected tissue, either by increased cell proliferation or fibrosis. Palpation is the oldest method for the detection of thyroid nodules, which is informed by the knowledge that malignant thyroid lesions tend to be much harder than benign ones. Unfortunately, palpation is a highly subjective method that is dependent on the size and location of the lesion, as well as on the skill of the physician. In cases where these nodules are very small or are located in deep regions, their detection by palpation is difficult or even impossible. In addition, although a malignant lesion differs in terms of elasticity, it may not have echogenic properties, preventing its detection by conventional ultrasound. Imaging that indicates the stiffness or deformation of tissues, through the use of ultrasound elastography techniques, adds new information related to their structural formation. In this article, we review the basic physical principles of elastography and the evolution of the method for the evaluation of thyroid nodules, as well as the limitations of and future perspectives for its use.
Highlights
Ultrasound elastography techniques measure the elasticity of tissues in order to produce qualitative and quantitative information that can be used for diagnostic purposes in various diseases
We review the basic physical principles of elastography and the evolution of the method for the evaluation of thyroid nodules, as well as the limitations of and future perspectives for its use
Those findings were challenged by the results of a recent retrospective study of 703 nodules, which showed that the sensitivity of deformation measurements was 15.7% when the 5-point Rago score was applied and 65.4% when the 4-point Asteria score was applied, both lower than the 91.7% achieved with B-mode ultrasound[7]
Summary
Ultrasound elastography techniques measure the elasticity of tissues in order to produce qualitative and quantitative information that can be used for diagnostic purposes in various diseases. Ultrasound elastography techniques can be divided into compression imaging methods, which use internal or external deformation stimuli, and Radiol Bras. Moraes PHM et al / Elastography in the evaluation of thyroid nodule shear wave imaging methods, which use ultrasound-generated shear wave stimuli[1]. Elastography was invented in 1990, having since been undergoing modifications and technological advances that make it increasingly efficient and reproducible. Ultrasound elastography of the liver, for the noninvasive assessment of liver fibrosis, is already a reality in clinical diagnostic practice. There have been recent advances in the application of elastography for imaging of the breast, prostate, lymph nodes, and thyroid[2]
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