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European Radiology

, Volume 25, Issue 3, pp 624–634 | Cite as

Two-dimensional shear wave elastography as promising diagnostic tool for predicting malignant thyroid nodules: a prospective single-centre experience

  • Baoxian Liu
  • Jinyu Liang
  • Yanling Zheng
  • Xiaoyan XieEmail author
  • Guangliang Huang
  • Luyao Zhou
  • Wei Wang
  • Mingde Lu
Head and Neck

Abstract

Objectives

To evaluate the diagnostic performance of two-dimensional shear wave elastography (2D-SWE) in distinguishing malignant from benign thyroid nodules.

Methods

A total of 331 focal thyroid nodules from 271 patients scheduled for fine-needle aspiration or thyroid surgery were included. After a routine conventional ultrasound evaluation, 2D-SWE examinations were performed to obtain 2D-SWE measurements on a colour-coded mapping, which were then correlated with pathology results.

Results

A total of 230 nodules were benign and 101 were malignant on pathology. The areas under the receiver operating characteristic curve (AUC) of mean and minimum values in the largest region of interest (ROI) over the whole nodule, and mean, maximum and minimum values in 2-mm ROI over the stiffest area of the nodule were 0.794, 0.673, 0.808, 0.805 and 0.799, respectively. The most accurate cut-off value, 39.3 kPa, for mean value in a 2-mm ROI achieved 66.3 % sensitivity and 84.4 % specificity to discriminate malignancy. Nodule size correlated with 2D-SWE value for malignant nodules (P < 0.01). In the group of nodules ≤10 mm, the AUC was 0.730, while it was 0.883 in nodules sized 11–30 mm and 0.821 in nodules >30 mm.

Conclusion

2D-SWE is a promising diagnostic tool for discriminating malignant thyroid nodules, although the performance for nodules ≤10 mm is not satisfactory.

Key Points

2D-shear wave elastography (2D-SWE) helps differentiate benign nodules from malignancy.

Calcification will increase the 2D-SWE value.

2D-SWE appears limited in terms of identifying papillary thyroid microcarcinomas accurately.

Combination of 2D-SWE and conventional ultrasound is highly sensitivity for thyroid malignancy.

Keywords

2D-shear wave elastography Thyroid nodules Malignancy Ultrasound Fine-needle aspiration 

Abbreviations

2D-SWE

Two-dimensional shear wave elastography

AUC

Areas under the ROC curve

FNA

Fine-needle aspiration

NPV

Negative predictive value

PPV

Positive predictive value

ROC

Receiver operating characteristic

ROI

Region of interest

SWE_max

Maximum SWE value in the 2-mm ROI

SWE_mean

Mean SWE value in the 2-mm ROI

SWE_min

Minimum SWE value in the 2-mm ROI

SWE_whole_mean

Mean SWE value in the largest ROI

SWE_whole_min

Minimum SWE value in the largest ROI

SWE_ratio

Ratio between SWE_mean and the elastic value of the surrounding thyroid tissue

US

Ultrasound

Notes

Acknowledgments

The scientific guarantor of this publication is Xiaoyan Xie. The authors of this manuscript declare no relationships with any companies whose products or services may be related to the subject matter of the article. The authors state that this work has not received any funding. No complex statistical methods were necessary for this paper. Institutional review board approval was obtained. Written informed consent was obtained from all subjects (patients) in this study. Methodology: prospective, diagnostic or prognostic study, performed at one institution.

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Copyright information

© European Society of Radiology 2014

Authors and Affiliations

  • Baoxian Liu
    • 1
    • 3
  • Jinyu Liang
    • 1
    • 3
  • Yanling Zheng
    • 1
    • 3
  • Xiaoyan Xie
    • 1
    • 3
    Email author
  • Guangliang Huang
    • 1
    • 3
  • Luyao Zhou
    • 1
    • 3
  • Wei Wang
    • 1
    • 3
  • Mingde Lu
    • 2
    • 3
  1. 1.Department of Medical UltrasonicsThe First Affiliated Hospital of Sun Yat-Sen UniversityGuangzhouChina
  2. 2.Department of Hepatobiliary SurgerySun Yat-Sen UniversityGuangzhouChina
  3. 3.Division of Interventional Ultrasound, Institute of Diagnostic and Interventional UltrasoundThe First Affiliated Hospital of Sun Yat-Sen University, Sun Yat-Sen UniversityGuangzhouChina

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