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Diagnostic performance of gray-scale US and elastography in solid thyroid nodules

Authors
 Hee Jung Moon  ;  Ji Min Sung  ;  Eun-Kyung Kim  ;  Jung Hyun Yoon  ;  Ji Hyun Youk  ;  Jin Young Kwak 
Citation
 RADIOLOGY, Vol.262(3) : 1002-1013, 2012 
Journal Title
RADIOLOGY
ISSN
 0033-8419 
Issue Date
2012
MeSH
Adolescent ; Adult ; Aged ; Biopsy ; Diagnosis, Differential ; Elasticity Imaging Techniques/methods* ; Female ; Humans ; Logistic Models ; Male ; Middle Aged ; Predictive Value of Tests ; Retrospective Studies ; Sensitivity and Specificity ; Thyroid Nodule/diagnostic imaging* ; Thyroid Nodule/pathology ; Ultrasonography, Interventional
Keywords
Adolescent ; Adult ; Aged ; Biopsy ; Diagnosis, Differential ; Elasticity Imaging Techniques/methods* ; Female ; Humans ; Logistic Models ; Male ; Middle Aged ; Predictive Value of Tests ; Retrospective Studies ; Sensitivity and Specificity ; Thyroid Nodule/diagnostic imaging* ; Thyroid Nodule/pathology ; Ultrasonography, Interventional
Abstract
PURPOSE: To evaluate the diagnostic performance of gray-scale ultrasonography (US) and elastography in differentiating benign and malignant thyroid nodules.

MATERIALS AND METHODS: This was an institutional review board-approved retrospective study with waiver of informed consent. A total of 703 solid thyroid nodules in 676 patients (mean age, 49.7 years; range, 18-79 years) were included; there were 556 women (mean age, 49.5 years; range, 20-74 years) and 120 men (mean age, 50.7 years; range, 18-79 years). Nodules with marked hypoechogenicity, poorly defined margins, microcalcifications, and a taller-than-wide shape were classified as suspicious at grayscale US. Findings at elastography were classified according to the Rago criteria and the Asteria criteria. The diagnostic performances of gray-scale US and elastography were compared. For comparison between the diagnostic performances of gray-scale US and the combination of gray-scale US and elastography, three sets of criteria were assigned: criteria set 1, nodules with any suspicious grayscale US feature were assessed as suspicious; criteria set 2, Rago criteria were added as suspicious features to criteria set 1; and criteria set 3, Asteria criteria were added as suspicious features to criteria set 1. The diagnostic performances of gray-scale US, elastography with Rago criteria, and elastography with Asteria criteria, and odds ratios (ORs) with 95% confidence intervals for predicting thyroid malignancy were compared using generalized estimating equation analysis.

RESULTS: Of 703 nodules, 217 were malignant and 486 were benign. Sensitivity, negative predictive value (NPV), and OR of gray-scale US for the 703 nodules were 91.7%, 94.7%, and 22.1, respectively, and these values were higher than the 15.7% and 65.4% sensitivity, 71.7% and 79.1% NPV, and 3.7 and 2.6 ORs found for elastography with Rago and Asteria criteria, respectively. Specificity, positive predictive value, and accuracy for criteria set 1 were significantly higher than those for criteria sets 2 and 3 for most of the nodule subgroups that were considered.

CONCLUSION: Elastography alone, as well as the combination of elastography and gray-scale US, showed inferior performance in the differentiation of malignant and benign thyroid nodules compared with gray-scale US features; elastography was not a useful tool in recommending fine-needle aspiration biopsy.
Files in This Item:
T201200373.pdf Download
DOI
22357900
Appears in Collections:
1. College of Medicine (의과대학) > Research Institute (부설연구소) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실) > 1. Journal Papers
Yonsei Authors
Kwak, Jin Young(곽진영) ORCID logo https://orcid.org/0000-0002-6212-1495
Kim, Eun-Kyung(김은경) ORCID logo https://orcid.org/0000-0002-3368-5013
Moon, Hee Jung(문희정) ORCID logo https://orcid.org/0000-0002-5643-5885
Sung, Ji Min(성지민)
Youk, Ji Hyun(육지현) ORCID logo https://orcid.org/0000-0002-7787-780X
Yoon, Jung Hyun(윤정현) ORCID logo https://orcid.org/0000-0002-2100-3513
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/91777
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