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J Ultrasound Med. 2018 Jul;37(7):1777-1788. doi: 10.1002/jum.14531. Epub 2018 Jan 9.

Three-Dimensional Shear Wave Elastography for Differentiating Benign From Malignant Thyroid Nodules.

Zhao CK1,2,3, Chen SG4,5, Alizad A5, He YP1,2,3, Wang Q1,2,3, Wang D1,2,3, Yue WW1,2,3, Zhang K1,2,3, Qu S6,2, Wei Q4,2, Xu HX1,2,3.

Author information

1
Department of Medical Ultrasound, Shanghai Tenth People's Hospital, Ultrasound Research and Education Institute, Shanghai, China.
2
Shanghai Tenth People's Hospital, and Thyroid Institute, Tongji University School of Medicine, Shanghai, China.
3
Shanghai Center for Thyroid Diseases, Shanghai, China.
4
Departments of Endocrinology and Metabolism, Shanghai Tenth People's Hospital, Ultrasound Research and Education Institute, Shanghai, China.
5
Department of Radiology, Mayo Clinic, Rochester, Minnesota, USA.
6
Department of Pathology, Shanghai Tenth People's Hospital, and Thyroid Institute Tongji University School of Medicine, Shanghai, China.

Abstract

OBJECTIVES:

To prospectively evaluate the diagnostic performance of 3-dimensional (3D) shear wave elastography (SWE) for assessing thyroid nodules.

METHODS:

A total of 176 surgically or cytologically confirmed thyroid nodules (63 malignant and 113 benign) in 176 patients who had undergone conventional ultrasound (US), 2-dimensional (2D) SWE, and 3D SWE examinations were included in this study. Quantitative elasticity values (mean elasticity, maximum elasticity, and standard deviation of elasticity of a large region of interest and mean elasticity of a 2-mm region of interest) were measured on 2D and 3D SWE. Diagnostic performances of conventional US, 2D SWE, and 3D SWE were assessed. The role of 2D and 3D SWE in reducing unnecessary fine-needle aspiration (FNA) for nodules with low suspicion was also evaluated.

RESULTS:

The diagnostic performances in terms of the area under the receiver operating characteristic curve were 0.612 for conventional US, 0.836 for 2D SWE (P < .001 in comparison with conventional US), and 0.839 for 3D SWE (P < .001 in comparison with conventional US). The mean elasticity achieved the highest diagnostic performance in 2D SWE, whereas the standard deviation of elasticity achieved the highest performance in 3D SWE, although no significant difference was found between them (P > .05). Three-dimensional SWE increased the specificity in comparison with 2D SWE (88.5% versus 82.3%; P = .039). For the 37 nodules with low suspicion on conventional US imaging, 2D SWE was able to avoid unnecessary FNA in 77.1% (27 of 35) of benign nodules, and 3D SWE further increased the number to 88.6% (31 of 35).

CONCLUSIONS:

Three-dimensional SWE is a useful tool for predicting thyroid nodule malignancy and reducing unnecessary FNA procedures in thyroid nodules with low suspicion of malignancy.

KEYWORDS:

3-dimensional; elastography; head and neck; shear wave elastography; thyroid nodule; thyroid/parathyroid; ultrasound

PMID:
29315789
DOI:
10.1002/jum.14531
[Indexed for MEDLINE]

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