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J Ultrasound Med. 2018 Mar;37(3):725-736. doi: 10.1002/jum.14413. Epub 2017 Sep 28.

Assessment of Virtual Touch Tissue Imaging Quantification and the Ultrasound Thyroid Imaging Reporting and Data System in Patients With Thyroid Nodules Referred for Biopsy.

Mao F1,2,3, Xu HX1,2,4, Zhou H1,2,5, Bo XW1,2,4, Li XL1,2,4, Li DD1,2,4, Liu BJ1,2,4, Zhang YF1,2,4, Xu JM1,2,4, Qu S2,6,4.

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Department of Medical Ultrasound, Shanghai Tenth People's Hospital, Ultrasound Research and Education Institute, Shanghai, China.
Thyroid Institute, Tongji University School of Medicine, Shanghai, China.
Department of Ultrasound, Ningbo First Hospital, Ningbo, China.
Shanghai Center for Thyroid Diseases, Shanghai, China.
In-Patient Ultrasound Department, Second Affiliated Hospital of Harbin Medical University, Harbin, China.
Department of Endocrinology and Metabolism, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, China.



To evaluate the diagnostic performance of Virtual Touch tissue imaging quantification (VTIQ; Siemens Medical Solutions, Mountain View, CA) in combination with the Thyroid Imaging Reporting and Data System (TI-RADS) for assessing thyroid nodules referred for biopsy.


A total of 197 surgically or cytologically proven thyroid nodules in 187 patients were included. Nodules evaluated by conventional ultrasound (US) and VTIQ examinations were classified into US TI-RADS categories. The shear wave velocity (SWV) on VTIQ was assessed, and the cutoff value was obtained from a receiver operating characteristic curve analysis. Diagnostic performances of conventional US, VTIQ, and their combination were compared.


There were 134 benign and 63 malignant nodules. The sensitivity and specificity for the US TI-RADS were 98.4% and 20.1%, respectively. The areas under the receiver operating characteristic curves for the mean, maximum, minimum, and ratio of the SWV were 0.818, 0.805, 0.799, and 0.728. With a cutoff value of 2.90 m/s, the sensitivity and specificity of the mean SWV were 71.4% and 82.8%. By applying this value or less as a standard for downgrading TI-RADS category 4a to category 3 lesions, the specificity significantly rose from 20.1% to 47.0% (P < .001) without a loss of sensitivity.


The additional application of VTIQ can improve the specificity of the TI-RADS for evaluating thyroid nodules without a loss of sensitivity.


Thyroid Imaging Reporting and Data System; Virtual Touch tissue imaging quantification; elastography; shear wave elastography; thyroid nodule; thyroid/parathyroid; ultrasound

[Indexed for MEDLINE]

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