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Endocrine Abstracts (2011) 26 P374

1Department of Internal Medicine 1, J.W. Goethe-University Hospital, Frankfurt, Germany; 2Department of General and Visceral Surgery, J.W. Goethe-University Hospital, Frankfurt, Germany; 3Department of Nuclear Medicine, J.W. Goethe-University Hospital, Frankfurt, Germany; 4Institute of Pathology, J.W. Goethe-University Hospital, Frankfurt, Germany.


Objective: Acoustic radiation force impulse (ARFI)-imaging is a novel ultrasound-based elastography method enabling quantitative measurement of tissue stiffness. The aim of the present study was to evaluate the feasibility of ARFI-measurements in the thyroid tissue.

Materials and methods: ARFI-imaging involves the mechanical excitation of tissue using short-duration acoustic pulses to generate localized displacements in tissue. The displacements result in shear-wave propagation which is tracked using ultrasonic, correlation-based methods and recorded in m/s. Inclusion criteria were: nodules ≥1 cm, non-functioning or hypo-functioning on radionuclide scanning, and cytological/histological assessment. All patients received conventional ultrasound, real-time elastography (RTE) and ARFI-imaging.

Results: Sixty nodules in 55 patients were available for analysis. Fifty-seven nodules were benign on cytology/histology, and three nodules were papillary carcinoma. The median velocity of ARFI-imaging in the healthy nodule-free thyroid gland, as well as in benign and malignant thyroid nodules was 1.98 m/s (range: 1.20–3.63 m/s), 2.02 m/s (range: 0.92–3.97 m/s), and 4.30 m/s (range: 2.40–4.50 m/s) respectively. While no significant difference in median velocity was found between healthy thyroid tissue and benign thyroid nodules, a significant difference was found between malignant thyroid nodules on the one hand and healthy thyroid tissue (P=0.018) or benign thyroid nodules (P=0.014) on the other hand. A specificity of ARFI-imaging of 91% could be achieved using a cut-off of 3.1 m/s. This was comparable to the specificity of RTE with 91% in the present study.

Conclusions: ARFI can be performed in the thyroid tissue with reliable results. This novel quantitative elastography-method can be performed with high specificity in the diagnostic work-up of thyroid nodules. Larger studies are awaited.

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