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Value of 2D shear wave elastography in suspicious thyroid nodules

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Document Type : Research Paper

Abstract

Background: Thyroid nodules are found in one every two people, who checked under ultrasonography examination. Though only 4-7% are clinically noticeable, there is increased in cancer incidence. Shear wave elastography (SWE) is simple noninvasive method to differentiate between benign and malignant nodules.
Aim of the study: to assess the differences in shear wave elastography indices between benign and malignant thyroid nodules by generating a cutoff value with best sensitivity and specificity.
Patient and Methods: a total of 55 patients with solid thyroid nodules were evaluated by conventional ultrasonography and shear wave elastography were mean shear wave elasticity indices measured followed by ultrasound guided fine needle aspiration cytology ,were histopathology was available for 7 patients.
Results: the results shows that the mean shear wave elastography parameter were higher in malignant thyroid nodules compared with benign ones. Nodules
with irregular margins and micro-calcifications had significantly higher Mean elasticity and elasticity ratio (P<0.05) to those with macro-calcifications or no calcifications. Receiver operating characteristic curve analysis was constructed for shear wave elastography parameters as predictors of malignant thyroid nodules. The best predictors were Elasticity–mean (E-mean) of ˃47.2 with 94.1% sensitive, 97.4% specific, and 96.4% accurate in diagnosis of malignancy. When combining signs of high suspicion of malignancy (thyroid imaging reporting and data system 4-5 and cut point > 47.2 kilopascal of Elasticity- mean), the sensitivity was 82.4%, specificity was 97.4%, and accuracy was 92.7% in differentiation between benign and malignant thyroid nodules, with positive predictive value and negative predictive value of 93.3% and of 92.5%, respectively.
Conclusion: Shear wave elastography indices were all significantly higher in malignant thyroid nodules compared to benign ones. The cut-off value of Elasticity mean (E-mean) (47.2 kilopascal) had a sensitivity of 94.1, specificity 97.4, positive predictive value 94.1%, negative predictive value 97.4%, and an accuracy 96.4%.

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References
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Iraqi Postgraduate Medical Journal
Volume 23, Issue 3
July 2024
Page 361-368
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