The clinical value of ultrasound elastography in predicting malignant thyroid nodules
Objective: This study aims to evaluate the clinical value of ultrasound elastography (USE) in providing information on the nature of the thyroid nodules. This was performed using the elastography score and strain ratio in differentiating thyroid benign and malignant nodules and the histopathological...
Main Authors: | , , , , |
---|---|
Format: | Article |
Language: | English |
Published: |
SpringerOpen
2014-06-01
|
Series: | The Egyptian Journal of Radiology and Nuclear Medicine |
Subjects: | |
Online Access: | http://www.sciencedirect.com/science/article/pii/S0378603X14000527 |
id |
doaj-72a6eb8eae9a477da3da9ca30ad07e3e |
---|---|
record_format |
Article |
spelling |
doaj-72a6eb8eae9a477da3da9ca30ad07e3e2020-11-25T02:11:47ZengSpringerOpenThe Egyptian Journal of Radiology and Nuclear Medicine0378-603X2014-06-0145235335910.1016/j.ejrnm.2014.03.006The clinical value of ultrasound elastography in predicting malignant thyroid nodulesMona A. EL-Hariri0Tamer F. Taha Ali1Mohamed A. Tawab2Asmaa M.A. Magid3Abdel-Fattah EL-Shiekh4Department of Radio-diagnosis, Faculty of Medicine, Zagazig University, EgyptDepartment of Radio-diagnosis, Faculty of Medicine, Zagazig University, EgyptDepartment of Radio-diagnosis, Faculty of Medicine, Al-Azhar University, EgyptDepartment of Radio-diagnosis, Faculty of Medicine, Cairo University, EgyptDepartment of General Surgery, Faculty of Medicine, Al-Azhar University, EgyptObjective: This study aims to evaluate the clinical value of ultrasound elastography (USE) in providing information on the nature of the thyroid nodules. This was performed using the elastography score and strain ratio in differentiating thyroid benign and malignant nodules and the histopathological examination was used as the diagnostic standard of reference. Methods: We examined 84 thyroid nodules in 62 patients with ultrasound elastography. Elastography score was assigned based on a four-point scale according to the classification proposed by Itoh et al. with a score of 1 (low stiffness over the entire nodule) to a score of 4 (high stiffness over the entire nodule). Thyroid strain ratio (normal tissue to lesion strain ratio) was calculated. Histopathological results were the standard reference. The area under the curve (AUC) and the best cut-off point were both obtained using receiver-operating characteristic (ROC) curve analysis. The sensitivity, specificity, and accuracy of both techniques were calculated. Results: Fifty-four of the 84 nodules had scores of 1 and 2, and 50 of these nodules were diagnosed histopathologically as benign. Thirty of the 84 nodules had a score of 3 and 4, and 21 of these nodules were diagnosed histopathologically as malignant. The scores of 1 and 2 with Itoh criteria were significantly seen in benign nodules, whereas, scores of 3 and 4 were significantly seen in malignant nodules (p < 0.05) with sensitivity 84%, specificity 84.7%, PPV 70%, NPV 92.6% and accuracy 84.5%. The mean SR for the benign nodules and malignant ones was significantly different (2.92 ± 0.96 vs. 4.53 ± 0.82, p < 0.001). With ROC analysis, the best cut-off strain ratio point was 3.5 for differentiating benign and malignant nodules with area under the curve (AUC) = 0.87 (0.8–0.95). The sensitivity of the strain ratio was 88%, while the specificity was 86.4%, PPV = 73.3%, NPV = 94.4% and accuracy = 86.9%. Conclusions: Both the elastographic score and strain ratio are higher in malignant nodules than those in benign ones. Ultrasound elastography can provide quantitative information on thyroid nodule helping in differentiating benign and malignant ones.http://www.sciencedirect.com/science/article/pii/S0378603X14000527UltrasoundElastographyThyroidNoduleMalignant |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Mona A. EL-Hariri Tamer F. Taha Ali Mohamed A. Tawab Asmaa M.A. Magid Abdel-Fattah EL-Shiekh |
spellingShingle |
Mona A. EL-Hariri Tamer F. Taha Ali Mohamed A. Tawab Asmaa M.A. Magid Abdel-Fattah EL-Shiekh The clinical value of ultrasound elastography in predicting malignant thyroid nodules The Egyptian Journal of Radiology and Nuclear Medicine Ultrasound Elastography Thyroid Nodule Malignant |
author_facet |
Mona A. EL-Hariri Tamer F. Taha Ali Mohamed A. Tawab Asmaa M.A. Magid Abdel-Fattah EL-Shiekh |
author_sort |
Mona A. EL-Hariri |
title |
The clinical value of ultrasound elastography in predicting malignant thyroid nodules |
title_short |
The clinical value of ultrasound elastography in predicting malignant thyroid nodules |
title_full |
The clinical value of ultrasound elastography in predicting malignant thyroid nodules |
title_fullStr |
The clinical value of ultrasound elastography in predicting malignant thyroid nodules |
title_full_unstemmed |
The clinical value of ultrasound elastography in predicting malignant thyroid nodules |
title_sort |
clinical value of ultrasound elastography in predicting malignant thyroid nodules |
publisher |
SpringerOpen |
series |
The Egyptian Journal of Radiology and Nuclear Medicine |
issn |
0378-603X |
publishDate |
2014-06-01 |
description |
Objective: This study aims to evaluate the clinical value of ultrasound elastography (USE) in providing information on the nature of the thyroid nodules. This was performed using the elastography score and strain ratio in differentiating thyroid benign and malignant nodules and the histopathological examination was used as the diagnostic standard of reference.
Methods: We examined 84 thyroid nodules in 62 patients with ultrasound elastography. Elastography score was assigned based on a four-point scale according to the classification proposed by Itoh et al. with a score of 1 (low stiffness over the entire nodule) to a score of 4 (high stiffness over the entire nodule). Thyroid strain ratio (normal tissue to lesion strain ratio) was calculated. Histopathological results were the standard reference. The area under the curve (AUC) and the best cut-off point were both obtained using receiver-operating characteristic (ROC) curve analysis. The sensitivity, specificity, and accuracy of both techniques were calculated.
Results: Fifty-four of the 84 nodules had scores of 1 and 2, and 50 of these nodules were diagnosed histopathologically as benign. Thirty of the 84 nodules had a score of 3 and 4, and 21 of these nodules were diagnosed histopathologically as malignant. The scores of 1 and 2 with Itoh criteria were significantly seen in benign nodules, whereas, scores of 3 and 4 were significantly seen in malignant nodules (p < 0.05) with sensitivity 84%, specificity 84.7%, PPV 70%, NPV 92.6% and accuracy 84.5%. The mean SR for the benign nodules and malignant ones was significantly different (2.92 ± 0.96 vs. 4.53 ± 0.82, p < 0.001). With ROC analysis, the best cut-off strain ratio point was 3.5 for differentiating benign and malignant nodules with area under the curve (AUC) = 0.87 (0.8–0.95). The sensitivity of the strain ratio was 88%, while the specificity was 86.4%, PPV = 73.3%, NPV = 94.4% and accuracy = 86.9%.
Conclusions: Both the elastographic score and strain ratio are higher in malignant nodules than those in benign ones. Ultrasound elastography can provide quantitative information on thyroid nodule helping in differentiating benign and malignant ones. |
topic |
Ultrasound Elastography Thyroid Nodule Malignant |
url |
http://www.sciencedirect.com/science/article/pii/S0378603X14000527 |
work_keys_str_mv |
AT monaaelhariri theclinicalvalueofultrasoundelastographyinpredictingmalignantthyroidnodules AT tamerftahaali theclinicalvalueofultrasoundelastographyinpredictingmalignantthyroidnodules AT mohamedatawab theclinicalvalueofultrasoundelastographyinpredictingmalignantthyroidnodules AT asmaamamagid theclinicalvalueofultrasoundelastographyinpredictingmalignantthyroidnodules AT abdelfattahelshiekh theclinicalvalueofultrasoundelastographyinpredictingmalignantthyroidnodules AT monaaelhariri clinicalvalueofultrasoundelastographyinpredictingmalignantthyroidnodules AT tamerftahaali clinicalvalueofultrasoundelastographyinpredictingmalignantthyroidnodules AT mohamedatawab clinicalvalueofultrasoundelastographyinpredictingmalignantthyroidnodules AT asmaamamagid clinicalvalueofultrasoundelastographyinpredictingmalignantthyroidnodules AT abdelfattahelshiekh clinicalvalueofultrasoundelastographyinpredictingmalignantthyroidnodules |
_version_ |
1724912629705605120 |