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Ultrasound Med Biol. 2018 Mar;44(3):575-583. doi: 10.1016/j.ultrasmedbio.2017.11.017. Epub 2018 Jan 2.

Combination of Sonoelastography and TIRADS for the Diagnostic Assessment of Thyroid Nodules.

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Institute for Nuclear Medicine Hanau/Gießen/Frankfurt/Offenbach, Gießen, Germany. Electronic address:
Institute for Nuclear Medicine Hanau/Gießen/Frankfurt/Offenbach, Hanau, Germany.


To evaluate the diagnostic performance of elastography alone and combined with Thyroid Imaging Reporting And Data System (TIRADS) for the assessment of non-autonomous thyroid nodules. We included 244 thyroid nodules and analyzed the visual elasticity scores, strain value (SV) and TIRADS classification. Histologic examination revealed 38 malignant (16%) and 206 benign nodules. The SV was lower in malignant nodules than in benign with an optimal cutoff ≤0.225. The visual elasticity scores showed a better diagnostic performance than the SV measurement. The risk for malignancy increased with higher TIRADS category. The sensitivity, specificity, positive predictive value and negative predictive value of TIRADS were superior to sonoelastography. The combination of TIRADS ≥4C and SV ≤0.225 showed the highest odds ratio to predict malignancy. Kwak-TIRADS classification is superior to elastography for the differentiation of benign and malignant thyroid nodules. Our data demonstrate that a high TIRADS class alone is predictive for thyroid carcinoma and the clinical relevance of sonoelastography is negligible.


Elastography; Risk stratification; Strain value; TIRADS; Thyroid cancer; Thyroid ultrasound; Visual elasticity scores

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