Shear Wave Elastography Parameters Alone and in Combination with Conventional B-Mode Ultrasound Parameters for the Characterization of Thyroid Nodules: A Prospective Study

  • Purpose
    The aim of our study was to determine whether shear wave elastography (SWE) can improve the conventional B-mode differentiation of thyroid lesions.

    Methods
    We examined 119 patients with 169 thyroid nodules who prospectively underwent B-mode ultrasound and SWE using the same ultrasound machine. The parameters assessed using SWE were: mean elasticity within the entire lesion and mean and maximum elasticity for a 2-mm-diameter region of interest in the stiffest portion of the lesion, excluding microcalcifications. The discriminant powers of a generalized estimating equation model including B-mode parameters only and model including both B-mode and SWE parameters were assessed and compared, in association with pathologic verification.

    Results
    In total, 50 and 119 malignant and benign lesions were detected. The B-mode parameters associated with higher odds ratios for malignant lesions were microcalcifications, hypo-echogenicity and irregular margins. SWE-max was the only SWE independent parameter in differentiating between malignant and benign tumors. There was no significant difference in mean SWE values between patients with and without chronic autoimmune thyroiditis.

    Discussion & Conclusion
    The results of the present study suggest that SWE is a valuable tool for the characterization of thyroid nodules, with SWE-max being a significant parameter in differentiating benign and malignant lesions, independent of conventional B-mode parameters. The combination of SWE parameters and conventional B-mode parameters does not significantly improve the diagnosis of malignant thyroid nodules. The presence of microcalcifications can influence the SWE-whole value, whereas the presence of chronic autoimmune thyroiditis may not.

 

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