Assessment of perinodular stiffness in differentiating malignant from benign thyroid nodules

in Endocrine Connections
View More View Less
  • 1 L Hu, Department of Ultrasound, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui, , USTC, Hefei, China
  • 2 X Liu, Department of Ultrasound, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui, , USTC, Hefei, China
  • 3 C Pei, Department of Respiratory and critical care medicine, The First People's Hospital of Hefei City, The Third Affiliated Hospital of Anhui Medical University,, Anhui Medical College, Hefei, China
  • 4 L Xie, Department of Ultrasound, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui, , USTC, Hefei, China
  • 5 N He, Department of Ultrasound, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui, , USTC, Hefei, China

Correspondence: Nianan He, Email: henianan@ustc.edu.cn

Objective: We evaluated the diagnostic accuracy of perinodular stiffness, four risk stratification systems (RSSs) (KWAK-TIRADS, ACR-TIRADS, EU-TIRADS, and C-TIRADS), and the combination of perinodular stiffness and these four RSSs in differentiating malignant from benign thyroid nodules (TNs).

Methods: A total of 788 TNs in 726 patients were examined with conventional ultrasound (US) examination and sound touch elastography (STE). All TNs were classified by each of the four RSSs. The stiffness inside (E) the TNs was measured by STE. The stiffness of the 2.0mm perinodular region (Eshell) was measured with the Shell measurement function of STE. The diagnostic performances of four RSSs, the E values, and the Eshell values were evaluated. All TNs were further divided into subgroups based on size (≤ 10 mm group and > 10 mm group).

Results: Ninety-six TNs were classified as benign and 692 as malignant. Among the single-method approaches, ACR-TIRADS showed the highest AUC (0.77) for differentiating malignant from benign TNs for all TNs included. Eshell showed the highest AUC (0.75) in differentiating malignant from benign TNs for TNs with sizes ≤ 10 mm, and there were no significant differences in AUC among all single methods for diagnosis of TNs with sizes > 10 mm (P > 0.05). The combination of C-TIRADS and Eshell/E yielded the highest AUC for all TNs (0.83) and for TNs with size ≤ 10 mm (0.85) compared with other combinations.

Conclusions: Eshell/E combined with conventional US improves the diagnostic accuracy in TNs, and may reduce unnecessary fine needle aspiration.

 

     European Society of Endocrinology

     Society for Endocrinology

Sept 2018 onwards Past Year Past 30 Days
Abstract Views 0 0 0
Full Text Views 91 90 91
PDF Downloads 88 88 88