scholarly journals Combination of Maximum Shear Wave Elasticity Modulus and TIRADS Improves the Diagnostic Specificity in Characterizing Thyroid Nodules: A Retrospective Study

2018 ◽  
Vol 2018 ◽  
pp. 1-8 ◽  
Author(s):  
Jing Hang ◽  
Fan Li ◽  
Xiao-hui Qiao ◽  
Xin-hua Ye ◽  
Ao Li ◽  
...  
Keyword(s):  
Shear Wave ◽  
Diagnostic Performance ◽  
Operating Characteristic ◽  
Thyroid Nodules ◽  
Elasticity Modulus ◽  
Shear Wave Elastography ◽  
Diagnostic Value ◽  
Diagnostic Specificity ◽  
Log Normal ◽  
Log Normal Distribution

Objectives. The present study is aimed at evaluating the diagnostic value of combining shear wave elastography (SWE) parameters and the thyroid imaging reporting and data system (TIRADS) for differentiating between benign and malignant thyroid nodules. Methods. Patients who underwent conventional ultrasonography (US) and SWE before surgery were enrolled in the current study. Each nodule was given a TIRADS risk score. The effectiveness of the SWE parameters was assessed by odds ratios (ORs). The SWE scoring risk stratification was proposed beyond 95% probability, and the desired values were obtained according to the log-normal distribution. The area under the receiver-operating characteristic (AUC) was used to compare the diagnostic performance between TIRADS-alone and TIRADS + SWE. Results. A total of 262 patients with 298 thyroid nodules were enrolled in our study. The pathological analyses were conducted on 121 benign and 177 malignant nodules. The AUC values for TIRADS-alone and TIRADS + SWE were 0.896 (accuracy 83.2%) and 0.917 (accuracy 84.2%), respectively. However, the TIRADS + SWE scores showed a higher specificity (88.4%) and positive predictive value (91.2%) as compared with the TIRADS-alone of 73.6% and 83.2%, respectively. Conclusions. Combining SWE and TIRADS improves the specificity of TIRADS-alone in differentiating between benign and malignant thyroid nodules.

scholarly journals Accuracy of shear wave elastography in characterization of thyroid nodules in children and adolescents

2021 ◽  
Vol 12 (1) ◽  
Author(s):  
Mohammed Hazem ◽  
Ossama M. Zakaria ◽  
Mohamed Yasser Ibrahim Daoud ◽  
Ibrahim Khalid Al Jabr ◽  
Abdulwahab A. AlYahya ◽  
...  
Keyword(s):  
Children And Adolescents ◽  
Shear Wave ◽  
Diagnostic Performance ◽  
Thyroid Nodules ◽  
Shear Wave Elastography ◽  
Invasive Technique ◽  
Predictive Values ◽  
Patients Âgés ◽  
Non Invasive

Abstract Background Thyroid nodules are an important health problem in children and adolescents. They possess a higher risk of malignancy in comparison to adults. This fact forms a great dilemma for clinicians. The aim of this study was to evaluate the reliability of shear wave elastography (SWE) as a non-invasive technique in the characterization of thyroid nodules in children and adolescents. Methods This prospective study included 56 patients with thyroid nodules. All the patients underwent clinical assessment, laboratory investigations, ultrasound, and Doppler examination, followed by an SWE assessment. Statistical analysis was performed and the best cut-off value to differentiate benign from malignant nodules was determined using the ROC curve and AUC. Results Seventy-two nodules were detected in the examined patients (ages ranged from 11 to 19 years, with mean age of 14.89 ± 2.3 years). Fifty-eight nodules (80.6%) were benign, and fourteen nodules (19.4%) were malignant (histopathologically proved). Highly suspicious criteria for prediction of malignancy by ultrasound and Doppler were hypoechoic echopattern, internal or internal and peripheral vascularity, microcalcifications, taller-than-wide dimensions, irregular outlines, and absence of halo (p < 0.05). The diagnostic performance for their summation was 70.69% sensitivity, 82.8% specificity, 80.45% accuracy, a 63.79% positive predictive value (PPV), and 87.9% negative predictive values (NPV). Regarding SWE, our results showed that 42.2 kPa was the best cut-off value, with AUC = 0.921 to differentiate malignant from benign nodules; the diagnostic performance was 85.71% sensitivity, 94.83% specificity, 93.06% accuracy, 76.9% PPV, and 93.2% NPV. Conclusion Shear wave elastography is a non-invasive technique that can assist in the diagnosis of malignant thyroid nodules among children and adolescents.

Prospective Evaluation of Semiquantitative Strain Ratio and Quantitative 2D Ultrasound Shear Wave Elastography (SWE) in Association with TIRADS Classification for Thyroid Nodule Characterization

2019 ◽  
Vol 40 (04) ◽  
pp. 495-503 ◽  
Author(s):  
Vito Cantisani ◽  
Emanuele David ◽  
Hektor Grazhdani ◽  
Antonello Rubini ◽  
Maija Radzina ◽  
...  
Keyword(s):  
Thyroid Nodule ◽  
Shear Wave ◽  
Diagnostic Performance ◽  
Thyroid Nodules ◽  
Shear Wave Elastography ◽  
Strain Ratio ◽  
Ultrasound Elastography ◽  
Prospective Evaluation ◽  
2D Ultrasound

Abstract Purpose To evaluate the diagnostic performance of strain ratio elastography (SRE) and shear wave elastography (SWE) alone and in combination with Thyroid Imaging Reporting and Data System (TIRADS) classification parameters to improve differentiation between benign and malignant thyroid nodules. Materials and Methods In this prospective study benign (n = 191) and malignant (n = 52) thyroid nodules were examined with high-resolution ultrasound (US) features using the TIRADS lexicon and SRE semiquantitative and SWE quantitative findings using histology or cytology as the gold standard with a 12-month follow-up. Sensitivity (Se), specificity (Sp) and the area under the ROC curve (AUROC) were used to evaluate the diagnostic performance of each feature and combinations of the methods. Results TIRADS score showed a sensitivity of 59.6 %, a specificity of 83.8 % with an AUROC of 0.717, a PPV of 50.0 % and an NPV of 88.4 %. SRE yielded the highest performance with a sensitivity of 82.7 %, a specificity of 92.7 % with AUROC of 0.877, a PPV 75.4 % and an NPV of 95.2 %. SWE (kPa) had a sensitivity and specificity of 67.3 % and 82.7 %, respectively, with an AUROC of 0.750, a PPV of 51.5 % and an NPV of 90.3 %. Differences were significant for SRE only but not for SWE. Conclusion Ultrasound elastography may improve thyroid nodule discrimination. In particular, SRE has a better performance than TIRADS classification, while their combination improves sensitivity.

scholarly journals Diagnostic Performance of a Combination of Shear Wave Elastography and B-Mode Ultrasonography in Differentiating Benign From Malignant Thyroid Nodules

2020 ◽  
Vol 13 (2) ◽  
pp. 186-193
Author(s):  
Eung Koo Yeon ◽  
Yu-Mee Sohn ◽  
Mirinae Seo ◽  
Eui-Jong Kim ◽  
Young-Gyu Eun ◽  
...  
Keyword(s):  
Shear Wave ◽  
Predictive Value ◽  
Diagnostic Performance ◽  
Thyroid Nodules ◽  
Multivariate Logistic Regression Analysis ◽  
Shear Wave Elastography ◽  
Surgical Excision ◽  
Needle Aspiration ◽  
The Difference ◽  
Us Findings

Objectives. This study was conducted to compare clinicopathologic and radiologic factors between benign and malignant thyroid nodules and to evaluate the diagnostic performance of shear wave elastography (SWE) combined with B-mode ultrasonography (US) in differentiating malignant from benign thyroid nodules.Methods. This retrospective study included 92 consecutive patients with 95 thyroid nodules examined on B-mode US and SWE before US-guided fine-needle aspiration biopsy or surgical excision. B-mode US findings (composition, echogenicity, margin, shape, and calcification) and SWE elasticity parameters (maximum [E<sub>max</sub>], mean, minimum, and nodule-to-normal parenchymal ratio of elasticity) were reviewed and compared between benign and malignant thyroid nodules. The diagnostic performance of B-mode US and SWE for predicting malignant thyroid nodules was analyzed. The optimal cutoff values of elasticity parameters for identifying malignancy were determined. Diagnostic performance was compared between B-mode US only, SWE only, and the combination of B-mode US with SWE.Results. On multivariate logistic regression analysis, age (odds ratio [OR], 0.90; <i>P</i>=0.028), a taller-than-wide shape (OR, 11.3; <i>P</i>=0.040), the presence of calcifications (OR, 15.0; <i>P</i>=0.021), and E<sub>max</sub> (OR, 1.22; <i>P</i>=0.021) were independent predictors of malignancy in thyroid nodules. The combined use of B-mode US findings and SWE yielded improvements in sensitivity, the positive predictive value, the negative predictive value, and accuracy compared with the use of B-mode US findings only, but with no statistical significance.Conclusion. When SWE was combined with B-mode US, the diagnostic performance was better than when only B-mode US was used, although the difference was not statistically significant.

Application of Shear Wave Elastography in the Diagnosis of Thyroid Nodules of Thyroid Imaging Report and Data System

2020 ◽  
Vol 10 (4) ◽  
pp. 864-867
Author(s):  
Jia Zheng ◽  
Xiaoxin Wang ◽  
Xianjing Han ◽  
Chunyan Li ◽  
Jianan Wang ◽  
...  
Keyword(s):  
Young’S Modulus ◽  
Shear Wave ◽  
Thyroid Nodules ◽  
Ultrasound Examination ◽  
Young's Modulus ◽  
Shear Wave Elastography ◽  
Diagnostic Value ◽  
Data System ◽  
Thyroid Imaging ◽  
The Mean

The purpose of this study is to explore whether shear wave elastography has diagnostic value in distinguishing benign and malignant thyroid imaging report and data system (TI-RADS) nodules, so as to provide more accurate information for clinical diagnosis and treatment of thyroid nodules. In this study, 134 patients with thyroid nodules who underwent ultrasound examination from February 2018 to October 2018 are collected. Firstly, according to the diagnostic criteria proposed by Horvath, TI-RADS grading is performed on them, and 78 patients with TI-RADS4 single solid nodules are screened out. Secondly, conventional ultrasound examination is performed on all the researchers, and shear wave elastographies are obtained 1 week after the examination. Thirdly, parameters of each lesion are measured by ultrasound physicians, and the maximum, minimum and average values of Young's modulus of each lesion are recorded. The results show that the mean and maximum of Young's modulus of benign lesions are (26.31 ± 9.88) kPa and (51.36 ± 14.51) kPa, respectively, the mean and maximum of Young's modulus of malignant lesions are (48.36 ± 16.53) and (69.15 ± 19.98) kPa, respectively, and the area under the ROC curve of Emean and Emax is 0.852 and 0.748, respectively. Therefore, shear wave elastography is a new type of ultrasound elastography, which has the advantages of objectivity and little influence from operators without artificial pressure. It has high sensitivity, specificity and accuracy in diagnosing benign and malignant thyroid nodules. Among them, the average value of Young's modulus has the greatest diagnostic value.

Comparative Analysis of Diagnostic Value for Shear Wave Elastography and Real-Time Elastographic Imaging for Thyroid Nodules

2019 ◽  
Vol 9 (2) ◽  
pp. 334-338
Author(s):  
Qing Yang ◽  
Wenhong Zhou ◽  
Jiyu Li ◽  
Guojun Wu ◽  
Feng Ding ◽  
...  
Keyword(s):  
Differential Diagnosis ◽  
Positive Predictive Value ◽  
Negative Predictive Value ◽  
Shear Wave ◽  
Predictive Value ◽  
Thyroid Nodules ◽  
Shear Wave Elastography ◽  
Roc Curves ◽  
Diagnostic Value ◽  
Sensitivity Specificity

Objective: To compare the diagnostic value of shear wave elastography (SWE) and real-time elastography (RTE) in the diagnosis of benign and malignant thyroid nodules. Methods: A total of 34 patients who ever received thyroidectomy in our hospital from January 2016 to January 2018 were identified. Meanwhile, all the patients received SWE and RTE before surgery, and all the diagnoses were confirmed by pathological examinations. With respect to SWE technique, the Subject Operating Characteristics (ROC) curves were drawn, in order to obtain the optimal threshold and then make differential diagnoses of benign and malignant thyroid nodules. In terms of RTE, the Rago 5 scoring method was utilized to make differential diagnoses of benign and malignant thyroid nodules. Besides, the pathological examinations after surgery could be considered as the golden standard. At last, the sensitivity, specificity, accuracy, positive predictive value, and negative predictive value of SWE and RTE were calculated, respectively. Results: A total of 51 thyroid nodules were identified, and 41 nodules were benign, 10 nodules were malignant. On the basis of ROC curves, with respect to SWE, the best threshold for differential diagnosis of benign and malignant thyroid nodules is 38.3 kPa. The sensitivity, specificity, accuracy, positive predictive value, and negative predictive value of SWE were 72.7% (8/11), 85% (34/40), 82.4% (42/51), 68.4% (13/19), and 87.5% (35/40), respectively. And the diagnostic indicators of RTE were 81.8% (9/11), 87.5% (35/40), 84.3% (43/51), 73.7% (14/19), and 90.0% (36/40). The sensitivity of quasi-static elastography in differential diagnosis of benign and malignant thyroid nodules with diameter ≤1 cm was 87.5% (7/8), and the sensitivity of SWE was 50.0% (5/10). In addition, the accuracy of SWE in differential diagnosis of benign and malignant thyroid nodules with diameter ≥3 cm was 100% (6/6), and the accuracy of RTE for this kind of thyroid nodules was 66.7% (4/6). Conclusion: Both SWE and RTE technology have good application value in differential diagnosis of benign and malignant thyroid nodules. But, SWE is preferable when making diagnosis of benign and malignant thyroid nodules with diameter ≥3 cm, and RTE was superior in detecting benign and malignant thyroid nodules with diameter ≤1 cm.

scholarly journals The value of peri-lesional tissue stiffness and stiff rim sign in the differential diagnosis between benign and malignant breast lesions

2019 ◽  
Author(s):  
wen-tao Kong ◽  
yin Wang ◽  
wei-jun Zhou ◽  
yi-dang Zhang ◽  
xiao-ming Zhuang ◽  
...  
Keyword(s):  
Shear Wave ◽  
Diagnostic Performance ◽  
Breast Lesion ◽  
Elasticity Modulus ◽  
Shear Wave Elastography ◽  
Surrounding Tissue ◽  
Pathological Examination ◽  
Breast Lesions ◽  
Tissue Stiffness ◽  
Malignant Lesions

Abstract Background Shear wave elastography (SWE) is an important method in the diagnosis of breast lesions. The purpose of this study was to evaluate the value of tissue stiffness around breast lesion and stiff rim sign for the differentiation of benign and malignant lesions. Methods 192 patients (mean age, 44.6 ± 13.6 years) with 199 breast lesions proven by pathological examination underwent shear wave elastography (SWE). We first observed if there was a stiff rim sign. Then the shell around the breast lesion on SWE was automatically drawn by machine, with width of 1mm, 2mm and 3mm. Elasticity modulus of the lesion and surrounding tissue were recorded, including maximum elasticity (Emax), mean elasticity (Emean), minimum elasticity (Emin) and elasticity ratio (shell/lesion ratio). The optimal thresholds of elasticity modulus were calculated according to receiver operating characteristic (ROC) curve. Results There were 75 malignant lesions and 124 benign lesions. The average Emax, Emean of lesion and shell were significantly higher in the malignant group than in the benign group (P<0.05). The optimal cut-off value of Emax for diagnosing malignant lesion was 101.7 Kpa, with a sensitivity of 66.3% and specificity of 87.9%. The optimal cut-off value of Emean was 29.1 Kpa, with a sensitivity of 65.3% and specificity of 79.8%. The stiff rim sign had a highest diagnostic performance for malignancy than other elastic parameters, with an accuracy of 88.4%. However, measuring peritumoral tissue stiffness can achieve a relatively high sensitivity, whereas specificity was not improved significantly. Conclusion The stiffness of tissue surrounding breast malignancy was significantly higher than benign lesion. Stiff rim sign has the potential to improve the diagnostic performance of breast lesions.

Suggested amendment of TI-RADS classification of thyroid nodules by shear wave elastography

2019 ◽  
Vol 61 (8) ◽  
pp. 1026-1033
Author(s):  
Jin-Ru Yang ◽  
Yan Song ◽  
Shan-Shan Xue ◽  
Li-Tao Ruan
Keyword(s):  
Shear Wave ◽  
Operating Characteristic ◽  
Thyroid Nodules ◽  
Characteristic Curve ◽  
Shear Wave Elastography ◽  
Needle Aspiration ◽  
Ultrasound Elastography ◽  
Conventional Ultrasound ◽  
Ultrasonic Shear

Background The application of the ultrasound elastography and Thyroid Imaging Reporting and Data System (TI-RADS) classification further expands the scope of ultrasound differential diagnosis between benign and malignant thyroid nodules. Purpose To investigate the value of the quantitative parameter of ultrasonic shear waves in optimizing the TI-RADS classification of thyroid nodules. Material and Methods A total of 168 thyroid nodules, initially classified using TI-RADS and scanned by shear wave elastography (SWE), were retrospectively analyzed. All cases were diagnosed by fine needle aspiration and histology following surgery. Results The benign rate of TI-RADS 3 nodules was 76.5%, while the benign rate of TI-RADS 4a nodules was 71.7%. Furthermore, the malignant rate of TI-RADS 4b nodules was 69.7%, while the malignant rate of TI-RADS 4c nodules was 85.7%. In differentiating benign from malignant nodules, the combination of TI-RADS classification and Emean had the largest area under the receiver operating characteristic curve (AUC). Using an Emean value of 42.25 kpa as the cut-off point, the malignant rate of TI-RADS 4a nodules decreased from 28.3% to 23.5%, while the malignant rate of TI-RADS 4b nodules increased from 69.7% to 79.4%. Compared to conventional ultrasound alone, the sensitivity, negative predictive value, and AUC of conventional ultrasound combined with SWE in the diagnosis of benign and malignant thyroid nodules significantly improved ( P=0.012, 0.029, 0.001). Conclusion The SWE technique can be used to further determine the benign and malignant nature of TI-RADS 4 lesions, providing further reference for the choice of clinical treatment. The TI-RADS classification system corrected by SWE is more significant in the diagnosis of benign and malignant thyroid nodules.

Performance of shear-wave elastography for breast masses using different region-of-interest (ROI) settings

2017 ◽  
Vol 59 (7) ◽  
pp. 789-797 ◽  
Author(s):  
Ji Hyun Youk ◽  
Eun Ju Son ◽  
Kyunghwa Han ◽  
Hye Mi Gweon ◽  
Jeong-Ah Kim
Keyword(s):  
Standard Deviation ◽  
Receiver Operating Characteristic ◽  
Shear Wave ◽  
Roc Curve ◽  
Diagnostic Performance ◽  
Operating Characteristic ◽  
Region Of Interest ◽  
Shear Wave Elastography ◽  
Breast Masses ◽  
The Mean

Background Various size and shape of region of interest (ROI) can be applied for shear-wave elastography (SWE). Purpose To investigate the diagnostic performance of SWE according to ROI settings for breast masses. Material and Methods To measure elasticity for 142 lesions, ROIs were set as follows: circular ROIs 1 mm (ROI-1), 2 mm (ROI-2), and 3 mm (ROI-3) in diameter placed over the stiffest part of the mass; freehand ROIs drawn by tracing the border of mass (ROI-M) and the area of peritumoral increased stiffness (ROI-MR); and circular ROIs placed within the mass (ROI-C) and to encompass the area of peritumoral increased stiffness (ROI-CR). Mean (Emean), maximum (Emax), and standard deviation (ESD) of elasticity values and their areas under the receiver operating characteristic (ROC) curve (AUCs) for diagnostic performance were compared. Results Means of Emean and ESD significantly differed between ROI-1, ROI-2, and ROI-3 ( P < 0.0001), whereas means of Emax did not ( P = 0.50). For ESD, ROI-1 (0.874) showed a lower AUC than ROI-2 (0.964) and ROI-3 (0.975) ( P < 0.002). The mean ESD was significantly different between ROI-M and ROI-MR and between ROI-C and ROI-CR ( P < 0.0001). The AUCs of ESD in ROI-M and ROI-C were significantly lower than in ROI-MR ( P = 0.041 and 0.015) and ROI-CR ( P = 0.007 and 0.004). Conclusion Shear-wave elasticity values and their diagnostic performance vary based on ROI settings and elasticity indices. Emax is recommended for the ROIs over the stiffest part of mass and an ROI encompassing the peritumoral area of increased stiffness is recommended for elastic heterogeneity of mass.

scholarly journals Conventional ultrasound, color Doppler, TI-RADS, and shear wave elastography for thyroid nodule differentiation: a study of efficacy compared with the histopathology results

2021 ◽  
Vol 52 (1) ◽  
Author(s):  
Ahmed Abd Alrahman Baz ◽  
Afaf Hamdy Ibrahim Mohamed ◽  
Yasmine Fathy Ghazi El-Esawy ◽  
Khaled Helmy El-kaffas
Keyword(s):  
Shear Wave ◽  
Diagnostic Performance ◽  
Thyroid Nodules ◽  
Color Doppler ◽  
Shear Wave Elastography ◽  
Color Doppler Imaging ◽  
Diagnostic Procedures ◽  
Doppler Imaging ◽  
Conventional Ultrasound ◽  
Histopathological Results

Abstract Background Although a minority of the thyroid nodules is malignant, usually the invasive diagnostic procedures are warranted. This prospective study aims to assess the diagnostic performance of the US criteria in addition to the TI-RADS score and the SWE for the differentiation between the benign and malignant thyroid nodules as a potential surrogate for the invasive procedures. Results Ninety-nine patients with thyroid nodules (79 females and 20 males, with a mean age of 45.9 ± 7.7 years; 30–69 years) were enrolled in this study and underwent conventional ultrasound, color Doppler, TI-RADS scoring, and shear wave elastography (SWE); the findings were correlated to the histopathological results. Our results revealed a significant increase in SWE elasticity indices (EIs) and presence of color Doppler signals in malignant nodules as compared with the benign ones (ρ < 0.05). Combined TI-RADS and SWE as well as TI-RADS and color Doppler imaging had given a better sensitivity for detection of malignancy. Conclusion Elasticity indices had shown a significantly high diagnostic performance that is almost approaching the histopathological results. Combined SWE, color Doppler and TI-RADS, as a sum of findings, could effectively differentiate between benign and malignant thyroid nodules. Furthermore, it had offered a non-invasive tool for accurate risk stratification of malignant nodules.

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