Abstract
To evaluate the associated factors leading to misdiagnosis with VTIQ for differentiation between benign from malignant thyroid nodules (TNs). The study included 238 benign TNs and 150 malignant TNs. Conventional ultrasound (US) features and VTIQ parameters were obtained and compared with the reference standard of histopathological and/or cytological results. Binary logistic regression analysis was performed to select independent variables leading to misdiagnosis. The maximum shear wave speed (SWS) (SWS-max), mean SWS (SWS-mean), SWS-ratio and standard deviation of SWS (SWS-SD) were significantly higher for malignant TNs compared with benign TNs (all P < 0.001). SWS-mean achieved the highest diagnostic performance with a cut-off value of 3.15 m/s. False positive rate was 13.4% (32/238) while false negative rate was 35.3% (53/150). Intranodular calcification (OR: 1.715) was significantly associated with false positive VTIQ findings, while nodule size (OR: 0.936) and echotexture of the thyroid gland (OR: 0.033) were negatively associated with them. Nodule depth (OR: 0.881) and TI-RADS category (OR: 0.563) were negatively associated with false negative VTIQ findings. These US characteristic of TNs should be taken into consideration when interpreting the results of VTIQ examinations.
Highlights
Shear wave (SW) imaging, known as shear wave elastography (SWE), has been introduced into clinical practice in recent years, which provides quantitative measurement of tissue stiffness instead of qualitative stiffness information with previous strain elastography[6,7]
To understand the factors relating to these false-positive or false-negative results is relevant in clinical practice, which may help the investigators to make correct decision when encountering a special clinical scenario
The aim of the study was to analyze the false virtual touch tissue imaging and quantification (VTIQ) results in the differential diagnosis between benign and malignant thyroid nodules (TNs) and to investigate the associated factors which led to false findings of TNs with VTIQ
Summary
Shear wave (SW) imaging, known as shear wave elastography (SWE), has been introduced into clinical practice in recent years, which provides quantitative measurement of tissue stiffness instead of qualitative stiffness information with previous strain elastography[6,7]. As a point SWS measurement technique, the utility of virtual touch tissue quantification (VTQ; Siemens Medical Solutions, Mountain View, CA, USA) in distinguishing malignancy from benign TNs has been reported in numerous studies[8,9,10,11]. It does not offer a 2D stiffness map of the TNs and is not able to provide guidance for selecting SW region of interest (ROI) for quantitative measurement.
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