Role of realtime elastography in diagnostic of thyroid cancer
D. Stoian, M. Cornianu & F. Lazar
Background: The most important aspect in the diagnostic approach of thyroid nodule is identifying the malignancy. Elastography is a newly technique that measures the elasticity of tissue, after applying a external force, standardized control. US elastography is currently used in differentiation of malignant from benign lesions.
Material, Method: This prospective study included 69 patients, mean age 50.08±12.43 years, 67 females and 2 men, with thyroid nodules on conventional US, with a volume higher than 0.20 ml: a total of 107 nodules. Conventional, Doppler ultrasound and real time sonoelastography was performed with a HITACHI EUB 7500 HV machine with 613 MHz variable frequency linear probe, with Doppler and elastography software, with recording of frames of all lesions prospectively on color elastography color map 1 (red-yellow-green-blue color map); Hitachi Medical System, Tokyo, Japan. All patients underwent surgery after complete evaluation. Extemporaneous and postsurgical histopathological exam was performed in all cases. Tissue stiffness was scored from one (greatest elasticity) to 5 (no strain), according to the UENO scale.
Results: ###27 nodules had score 1 on US elastography and 37 nodules had score 2. All nodules were benign on histopathological exam. Score 3 was found in 33 cases, 32 benign and one papillary carcinoma. Score 4 as found in 10 cases, all carcinomas. ES score of 4 is highly predictive for malignancy (sensitivity of 90.9%, specificity of 98.96%, positive predictive value of 100%, negative predictive value if 98.60%). The diagnostic quality of elastography was independent of the nodule volume.
Conclusion: US elastography has a good potential in diagnosing thyroid malignancy, independent of nodule volume, allowing the study of small nodules, less than 0.5 ml.
Predictive value of us elastography in patients with histopathological diagnostic
Declaration of interest: The authors declare that there is no conflict of interest that could be perceived as prejudicing the impartiality of the research project.
Funding: This research did not receive any specific grant from any funding agency in the public, commercial or not-for-profit sector