Elastography based on tissue Doppler in the diagnosis of thyroid nodules: a pilot study
Zbigniew Adamczewski1, Kinga Krawczyk-Rusiecka1, Marek Dedecjus2, Jan Brzezinski2 & Andrzej Lewinski1
Objective: Aiming at the highest specifity in differentiating benign from malignant thyroid nodules effects in new diagnostics developments. Recent technologies such as elastography enable determination of tissue stiffness difference between focal lesions and surrounding thyroid tissue reference tissue. This method is based on quantifying the stiffness of the lesion the malignant changes show decreased elasticity when compared to adjacent tissue. Tissue Doppler used in Toshiba ultrasound system requires external tissue compression made by the researcher by means of the transducer. Due to individual technique differences, some artifacts interfering the diagnosis may occur during examination.
Design: The aim of the study was to assess a potential role of elastography based on tissue Doppler in the diagnosis of focal thyroid lesions.
In this study, 100 thyroid nodules in 76 consecutive patients were examined (68 women, 15 men), using Toshiba Aplio XG ultrasound with linear PLT 1204 BT transducer. Final diagnoses were obtained from cytological and, in 54 cases, histological evaluation. There were 5 cases of papillary thyroid carcinoma, 1 case of anaplastic carcinoma, and 70 benign nodules. After achieving final results all the conducted examinations were reviewed.
Results: Retrospective evaluation study revealed presence of the artifacts causing different outcomes. The results interpretation was more difficult in nodules localized between isthmus and thyroid lobes, in peripheral thyroid and in cases when the lesion and lobe transverse parameters were equal.
Conclusions: Elastographic examination based on tissue Doppler imaging reveal stiffness differences between thyroid lesions and reference tissue. The awareness of the circumstances of artifacts appearing and correct examination technique are crucial for proper results interpretation. Nevertheless, prospective studies are needed to define useful applications and the clinical significance of the method.