Comparing the Sensitivity and Specificity of Two-Dimensional Shear Wave Elastography and Fine Needle Aspiration in Determining Malignant Thyroid Nodules

Farghadani, Maryam; Tabatabaei, Sayyid Amir; Barikbin, Roozbeh; Shahsanai, Armindokht; Riahinezhad, Maryam; Jafarpishe, Saleh

Comparing the Sensitivity and Specificity of Two-Dimensional Shear Wave Elastography and Fine Needle Aspiration in Determining Malignant Thyroid Nodules

Document Type : Original Article

Authors

¹ Department of Radiology, Isfahan university of Medical Sciences, Isfahan, Iran

² Department of Community and Family Medicine, Isfahan university of Medical Sciences, Isfahan, Iran

Abstract

Background: Malignancy in thyroid nodules is a common clinical problem, and epidemiological studies have shown that it is increasing. Since malignancy is a very important problem in treating patients and misdiagnosis leads to many physical and financial damages, the importance of diagnostic methods becomes more important. Hence, the aim of this study was to investigate the sensitivity and specificity of the two dimensional-shear wave elastography (2D-SWE) diagnostic method in comparison with fine-needle aspiration (FNA) in determining the malignant thyroid nodules. Materials and Methods: This study is cross-sectional which was performed on 57 thyroid nodules are proven by conventional ultrasound. Afterward, 2D-SWE images were taken with the help of a superSonic ultrasound machine. Then, FNA was performed from the thyroid nodules and the specimens were evaluated in a single specialized thyroid pathology center. The results of conventional sonography and 2D-SWE were compared with histopathologic results as a gold standard method. The elasticity quantity was recorded by measuring the amount of the appropriate quantities by a recording machine and analyzed using the SPSS and MedCalc software. Results: From 57 nodules studied, 50 nodules were evaluated with benign diagnosis and 7 nodules with the malignant diagnosis. Among all the parameters recorded by the machine, SWE. ratio provided the highest surface area under the curve and the highest sensitivity and specificity with 0.94, 100% and 84%, respectively, and a cut-off point of 1.7. Conclusion: The 2D-SWE method and the conventional ultrasound can be good references for decision making about with the thyroid nodules.

Keywords

References

1.	Dean DS, Gharib H. Epidemiology of thyroid nodules. Best Pract Res Clin Endocrinol Metab 2008;22:901-11.
2.	Moon JH, Hyun MK, Lee JY, Shim JI, Kim TH, Choi HS, et al. Prevalence of thyroid nodules and their associated clinical parameters: A large-scale, multicenter-based health checkup study. Korean J Intern Med 2018;33:753-62.
3.	Kitahara CM, Sosa JA. The changing incidence of thyroid cancer. Nat Rev Endocrinol 2016;12:646-53.
4.	Bahar A, Kashi Z, Akha A. The result of fine- needle- aspiration of thyroid nodule in patient referred to Imam Hospital Sari 2003-2011. J Mazand Univ Med Sci 2012;22:11-6.
5.	Sebag F, Vaillant-Lombard J, Berbis J, Griset V, Henry JF, Petit P, et al. Shear wave elastography: A new ultrasound imaging mode for the differential diagnosis of benign and malignant thyroid nodules. J Clin Endocrinol Metab 2010;95:5281-8.
6.	Magri F, Chytiris S, Capelli V, Alessi S, Nalon E, Rotondi M, et al. Shear wave elastography in the diagnosis of thyroid nodules: Feasibility in the case of coexistent chronic autoimmune Hashimoto's thyroiditis. Clin Endocrinol (Oxf) 2012;76:137-41.
7.	Liu B, Liang J, Zheng Y, Xie X, Huang G, Zhou L, et al. Two-dimensional shear wave elastography as promising diagnostic tool for predicting malignant thyroid nodules: A prospective single-centre experience. Eur Radiol 2015;25:624-34.
8.	Bhatia KS, Tong CS, Cho CC, Yuen EH, Lee YY, Ahuja AT, et al. Shear wave elastography of thyroid nodules in routine clinical practice: Preliminary observations and utility for detecting malignancy. Eur Radiol 2012;22:2397-406.
9.	Kim H, Kim JA, Son EJ, Youk JH. Quantitative assessment of shear-wave ultrasound elastography in thyroid nodules: Diagnostic performance for predicting malignancy. Eur Radiol 2013;23:2532-7.
10.	Veyrieres JB, Albarel F, Lombard JV, Berbis J, Sebag F, Oliver C, et al. A threshold value in shear wave elastography to rule out malignant thyroid nodules: A reality? Eur J Radiol 2012;81:3965-72.
11.	Shuzhen C. Comparison analysis between conventional ultrasonography and ultrasound elastography of thyroid nodules. Eur J Radiol 2012;81:1806-11.
12.	Liu BX, Xie XY, Liang JY, Zheng YL, Huang GL, Zhou LY, et al. Shear wave elastography versus real-time elastography on evaluation thyroid nodules: A preliminary study. Eur J Radiol 2014;83:1135-43.
13.	Ferraioli G, Tinelli C, Dal Bello B, Zicchetti M, Filice G, Filice C, et al. Accuracy of real-time shear wave elastography for assessing liver fibrosis in chronic hepatitis C: A pilot study. Hepatology 2012;56:2125-33.
14.	Kwon HJ, Kang MJ, Cho JH, Oh JY, Nam KJ, Han SY, et al. Acoustic radiation force impulse elastography for hepatocellular carcinoma-associated radiofrequency ablation. World J Gastroenterol 2011;17:1874-8.
15.	Wang Y, Dan HJ, Dan HY, Li T, Hu B. Differential diagnosis of small single solid thyroid nodules using real-time ultrasound elastography. J Int Med Res 2010;38:466-72.
16.	Tozaki M, Fukuma E. Pattern classification of ShearWave™ Elastography images for differential diagnosis between benign and malignant solid breast masses. Acta Radiol 2011;52:1069-75.

Advanced Biomedical Research