EP52 – US Elastography Using Carotid Artery Pulsation May Increase the Diagnostic Accuracy for Thyroid Nodules with US-Pathology Discordance

      Ha, Eun Ju1; Cho, Yoon Joo1; Han, Miran1; Choi, Jin Wook1 1 Department of Radiology, Ajou University School of Medicine, Wonchon-Dong, Yeongtong-Gu, Suwon, Korea Purpose: To prospectively evaluate the diagnostic performance of ultrasound elastography (USE) using carotid arterial pulsation and to determine interobserver and intraobserver agreements of USE for thyroid nodules. Materials and Methods: US examination and USE using carotid artery pulsation were performed in 148 patients with 173 nodules in a prospective design. The US features and elasticity contrast index (ECI) were assessed by observer 1 and the ECI was reassessed by observer 2. ROC curve analysis was performed to evaluate the diagnostic performance and to compare the AUC (Az) values of gray-scale US, ECI, and a combined assessment. Intraclass correlation coefficient (ICC) value was used to evaluate the interobserver and intraobserver agreements in the measured ECI values. Results: Among a total of 173 nodules, 95 nodules were malignant and 78 nodules were benign. The mean ECI was significantly higher in malignant nodules (3.1 ± 1.5) than in benign nodules (1.7 ± 0.8) (p < 0.001). The Az values of each dataset were 0.768 (95% CI, 0.698–0.828) for gray-scale US, 0.695 (0.621–0.763) for ECI, and 0.782 (0.713–0.841) for a combined assessment. ICC for interobserver agreement was 0.96 (p < 0.001), and for intraobserver agreement were 0.97 (p < 0.001) and 0.98 (p < 0.001) for observer 1 and 2, respectively. Excellent interobserver and intraobserver agreement was found in thyroid USE. Conclusion: USE using carotid artery pulsation may have a potential role to increase the diagnostic accuracy for nodules with US-pathology discordance with reproducible results.   References:
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