Diagnostic Performance of a Combination of Shear Wave Elastography and B-Mode Ultrasonography in Differentiating Benign From Malignant Thyroid Nodules
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Objectives. This study was conducted to compare clinicopathologic and radiologic factors between benign and malignant thyroid nodules and to evaluate the diagnostic performance of shear wave elastography (SWE) combined with B-mode ultrasonography (US) in differentiating malignant from benign thyroid nodules. Methods. This retrospective study included 92 consecutive patients with 95 thyroid nodules examined on B-mode US and SWE before US-guided fine-needle aspiration biopsy or surgical excision. B-mode US findings (composition, echogenicity, margin, shape, and calcification) and SWE elasticity parameters (maximum [Emax], mean, minimum, and nodule-to-normal parenchymal ratio of elasticity) were reviewed and compared between benign and malignant thyroid nodules. The diagnostic performance of B-mode US and SWE for predicting malignant thyroid nodules was analyzed. The optimal cutoff values of elasticity parameters for identifying malignancy were determined. Diagnostic performance was compared between B-mode US only, SWE only, and the combination of B-mode US with SWE. Results. On multivariate logistic regression analysis, age (odds ratio [OR], 0.90; P=0.028), a taller-than-wide shape (OR, 11.3; P=0.040), the presence of calcifications (OR, 15.0; P=0.021), and Emax (OR, 1.22; P=0.021) were independent predictors of malignancy in thyroid nodules. The combined use of B-mode US findings and SWE yielded improvements in sensitivity, the positive predictive value, the negative predictive value, and accuracy compared with the use of B-mode US findings only, but with no statistical significance. Conclusion. When SWE was combined with B-mode US, the diagnostic performance was better than when only B-mode US was used, although the difference was not statistically significant.
Abstract
Objectives. This study was conducted to compare clinicopathologic and radiologic factors between benign and malignant thyroid nodules and to evaluate the diagnostic performance of shear wave elastography (SWE) combined with B-mode ultrasonography (US) in differentiating malignant from benign thyroid nodules. Methods. This retrospective study included 92 consecutive patients with 95 thyroid nodules examined on B-mode US and SWE before US-guided fine-needle aspiration biopsy or surgical excision. B-mode US findings (composition, echogenicity, margin, shape, and calcification) and SWE elasticity parameters (maximum [Emax], mean, minimum, and nodule-to-normal parenchymal ratio of elasticity) were reviewed and compared between benign and malignant thyroid nodules. The diagnostic performance of B-mode US and SWE for predicting malignant thyroid nodules was analyzed. The optimal cutoff values of elasticity parameters for identifying malignancy were determined. Diagnostic performance was compared between B-mode US only, SWE only, and the combination of B-mode US with SWE. Results. On multivariate logistic regression analysis, age (odds ratio [OR], 0.90; P=0.028), a taller-than-wide shape (OR, 11.3; P=0.040), the presence of calcifications (OR, 15.0; P=0.021), and Emax (OR, 1.22; P=0.021) were independent predictors of malignancy in thyroid nodules. The combined use of B-mode US findings and SWE yielded improvements in sensitivity, the positive predictive value, the negative predictive value, and accuracy compared with the use of B-mode US findings only, but with no statistical significance. Conclusion. When SWE was combined with B-mode US, the diagnostic performance was better than when only B-mode US was used, although the difference was not statistically significant.
참고문헌 (28)
- Kim EK, "New sonographic criteria for recommending fine-needle aspiration biopsy of nonpalpable solid nodules of the thyroid", AJR Am J Roentgenol, 178(3), pp.687~691 (2002)
- 하은주, "A Multicenter Prospective Validation Study for the Korean Thyroid Imaging Reporting and Data System in Patients with Thyroid Nodules", Korean Journal of Radiology, 17(5), pp.811~821 (2016), 대한영상의학회[DOI]
- Hoang JK, "US Features of thyroid malignancy : pearls and pitfalls", Radiographics, 27(3), pp.847~860 (2007)
- Iannuccilli JD, "Risk for malignancy of thyroid nodules as assessed by sonographic criteria : the need for biopsy", J Ultrasound Med, 23(11), pp.1455~1464 (2004)
- Alexander EK, "Approach to the patient with a cytologically indeterminate thyroid nodule", J Clin Endocrinol Metab, 93(11), pp.4175~4182 (2008)
- Castro MR, "Thyroid fine-needle aspiration biopsy : progress, practice, and pitfalls", Endocr Pract, 9(2), pp.128~136 (2003)
- Cosgrove D, "WFUMB guidelines and recommendations on the clinical use of ultrasound elastography. Part 4: thyroid", Ultrasound Med Biol, 43(1), pp.4~26 (2017)
- Ophir J, "Elastography : a quantitative method for imaging the elasticity of biological tissues", Ultrason Imaging, 13(2), pp.111~134 (1991)
- Nell S, "Qualitative elastography can replace thyroid nodule fine-needle aspiration in patients with soft thyroid nodules : a systematic review and meta-analysis", Eur J Radiol, 84(4), pp.652~661 (2015)
- Asteria C, "US-elastography in the differential diagnosis of benign and malignant thyroid nodules", Thyroid, 18(5), pp.523~531 (2008)
- Monpeyssen H, "Elastography of the thyroid", Diagn Interv Imaging, 94(5), pp.535~544 (2013)
- Tanter M, "Quantitative assessment of breast lesion viscoelasticity : initial clinical results using supersonic shear imaging", Ultrasound Med Biol, 34(9), pp.1373~1386 (2008)
- Athanasiou A, "Breast lesions : quantitative elastography with supersonic shear imaging--preliminary results", Radiology, 256(1), pp.297~303 (2010)
- Liu BX, "Shear wave elastography versus real-time elastography on evaluation thyroid nodules : a preliminary study", Eur J Radiol, 83(7), pp.1135~1143 (2014)
- Cantisani V, "Prospective evaluation of multiparametric ultrasound and quantitative elastosonography in the differential diagnosis of benign and malignant thyroid nodules : preliminary experience", Eur J Radiol, 81(10), pp.2678~2683 (2012)
- Shuzhen C, "Comparison analysis between conventional ultrasonography and ultrasound elastography of thyroid nodules", Eur J Radiol, 81(8), pp.1806~1811 (2012)
- Colakoglu B, "Elastography in distinguishing benign from malignant thyroid nodules", J Clin Imaging Sci, 6, pp.51~ (2016)
- Park AY, "Shear wave elastography of thyroid nodules for the prediction of malignancy in a large scale study", Eur J Radiol, 84(3), pp.407~412 (2015)
- Veyrieres JB, "A threshold value in Shear Wave elastography to rule out malignant thyroid nodules: a reality?", Eur J Radiol, 81(12), pp.3965~3972 (2012)
- Chen M, "Shear wave elastography and contrast-enhanced ultrasonography in the diagnosis of thyroid malignant nodules", Mol Clin Oncol, 5(6), pp.724~730 (2016)
- Liu Z, "Shear wave elastography combined with the thyroid imaging reporting and data system for malignancy risk stratification in thyroid nodules", Oncotarget, 8(26), pp.43406~43416 (2017)
- Haugen BR, "2015 American Thyroid Association management guidelines for adult patients with thyroid nodules and differentiated thyroid cancer : the American Thyroid Association guidelines task force on thyroid nodules and differentiated thyroid cancer", Thyroid, 26(1), pp.1~133 (2016)
- Azizi G, "Thyroid nodules and shear wave elastography : a new tool in thyroid cancer detection", Ultrasound Med Biol, 41(11), pp.2855~2865 (2015)
- Kwak JY, "Thyroid imaging reporting and data system for US features of nodules : a step in establishing better stratification of cancer risk", Radiology, 260(3), pp.892~899 (2011)
- Na DG, "Thyroid imaging reporting and data system risk stratification of thyroid nodules : categorization based on solidity and echogenicity", Thyroid, 26(4), pp.562~572 (2016)
- 신정희, "Ultrasonography Diagnosis and Imaging-Based Management of Thyroid Nodules: Revised Korean Society of Thyroid Radiology Consensus Statement and Recommendations", Korean Journal of Radiology, 17(3), pp.370~395 (2016), 대한영상의학회[DOI]
- Wang D, "The diagnostic performance of shear wave speed(SWS)imaging for thyroid nodules with elasticity modulus and SWS measurement", Oncotarget, 8(8), pp.13387~13399 (2017)
- Bhatia KS, "Shear wave elastography of thyroid nodules in routine clinical practice : preliminary observations and utility for detecting malignancy", Eur Radiol, 22(11), pp.2397~2406 (2012)