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Sci Rep. 2017 Feb 3;7:41958. doi: 10.1038/srep41958.

Virtual touch tissue imaging and quantification (VTIQ) in the evaluation of thyroid nodules: the associated factors leading to misdiagnosis.

Sun CY1,2,3,4, Lei KR2, Liu BJ1,3,4, Bo XW1,3,4, Li XL1,3,4, He YP1,4, Wang D1,3,4, Ren WW1,3,4, Zhao CK1,3,4, Xu HX1,3,4.

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Department of Medical Ultrasound, Shanghai Tenth People's Hospital, Ultrasound Research and Education Institute, Tongji University School of Medicine, Shanghai 200072, China.
Department of Medical Ultrasound, Yangpu Hospital, Tongji University School of Medicine, Shanghai 200090, China.
Thyroid Institute, Tongji University School of Medicine, Shanghai 200072, China.
Shanghai Center for Thyroid Diseases, Shanghai, 200072, China.


To evaluate the associated factors leading to misdiagnosis with VTIQ for differentiation between benign from malignant thyroid nodules (TNs). The study included 238 benign TNs and 150 malignant TNs. Conventional ultrasound (US) features and VTIQ parameters were obtained and compared with the reference standard of histopathological and/or cytological results. Binary logistic regression analysis was performed to select independent variables leading to misdiagnosis. The maximum shear wave speed (SWS) (SWS-max), mean SWS (SWS-mean), SWS-ratio and standard deviation of SWS (SWS-SD) were significantly higher for malignant TNs compared with benign TNs (all P < 0.001). SWS-mean achieved the highest diagnostic performance with a cut-off value of 3.15 m/s. False positive rate was 13.4% (32/238) while false negative rate was 35.3% (53/150). Intranodular calcification (OR: 1.715) was significantly associated with false positive VTIQ findings, while nodule size (OR: 0.936) and echotexture of the thyroid gland (OR: 0.033) were negatively associated with them. Nodule depth (OR: 0.881) and TI-RADS category (OR: 0.563) were negatively associated with false negative VTIQ findings. These US characteristic of TNs should be taken into consideration when interpreting the results of VTIQ examinations.

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