Introduction: According to a high prevalence and relatively low occurrence of malignancies in thyroid nodular disease (TND), the selection of suspicious lesions for fine needle aspiration biopsy (FNAB) seem to be a vital problem in the daily endocrinological practice. Beside deciding if the FNAB is necessary, frequently the second problem occurs which nodule or nodules should be chosen in case of multinodular goiter (MNG), when the number of potential lesions for FNAB is high. The goal of this study was to compare the usefulness of conventional ultrasonography (US) and novel method of tissue stiffness assessment shear wave elastography (SWE) in the differentiation between malignant and benign nodules and in the selection of most suspicious lesions in MNG.
Materials and methods: Subjects with MNG, referred for thyroidectomy irrespectively of indications for surgery, underwent thyroid US and SWE before the surgical procedure. Results of these examinations were further correlated with the histopathological outcomes.
Results: Eighty patients with 339 thyroid nodules were included. Ten thyroid cancers (TCs) in ten patients were diagnosed in histopathology. All ten malignancies were the least elastic lesions in MNG (using quantitative data on maximal tissue stiffness). Four cancers appeared the biggest lesions in MNG, while one was equally the biggest in particular goiter (there were other lesions with the same size) taking into account maximal diameter. Three of ten cancers possessed the highest number of suspicious features in MNG, further four had the highest number equally with at least one other lesion in the same goiter.
Conclusions: On the basis of our results the relatively high stiffness of the lesion in comparison with other nodules from same MNG, should be considered as strong argument for choosing this particular one for FNAB.