Ah Young Park MD, Presenter: Nothing to Disclose

Eun Ju Son MD, PhD, Abstract Co-Author: Nothing to Disclose

Kyunghwa Han BS, Abstract Co-Author: Nothing to Disclose

Ji Hyun Youk MD, Abstract Co-Author: Nothing to Disclose

Jeong-Ah Kim MD, PhD, Abstract Co-Author: Nothing to Disclose

Cheong Soo Park, Abstract Co-Author: Nothing to Disclose

To validate the usefulness of shear wave elastography (SWE) in predicting thyroid malignancy with a large-scale quantitative SWE data.

This was an institutional review board–approved retrospective study with waiver of informed consent. 476 thyroid nodules in 453 patients who underwent gray-scale US and SWE before US-guided fine-needle aspiration biopsy (US-FNA) or surgical excision were included. Gray-scale findings and SWE elasticity indices (EIs) were retrospectively reviewed and compared between benign and malignant thyroid nodules. The optimal cut-off values of EIs for predicting malignancy were determined. The diagnostic performances of gray-scale US and SWE for predicting malignancy were analyzed and compared between the gray-scale US findings only and the combined use of gray-scale US findings with SWEs.

All EIs of malignant thyroid nodules were significantly higher than those of benign (P ≤ .001). The optimal cut-off values of each EI for predicting malignancy were Emean: 85.2kPa, Emax:94.0kPa, Emin: 54.0 kPa. Emean (OR 3.071, P=.005) or Emax (OR 3.015, P=.003) were the independent predictors of thyroid malignancy. Combined use of gray-scale US findings and each EI showed elevated sensitivity (95.0% to 95.5% vs 92.9%, P≤.005) and AUC (0.820 to 0.834 vs 0.769, P≤.005) for predicting malignancy, compared with the use of gray-scale US findings only.

Combining gray-scale US findings and each EI showed elevated sensitivity and elevated AUC for predicting malignancy, compared with the use of gray-scale US findings only. Therefore, we suggest that quantitative SWE finding of Emean ≥ 85 kPa or Emax ≥ 94 kPa with suspicious gray-scale US findings of thyroid nodules could be used as useful predictor for malignancy in routine clinical situation.

Quantitative parameters of SWE were predictive factors of thyroid malignancy and SWE evaluation combined with gray-scale US was adjunctive to the diagnostic performance of gray-scale US for predicting thyroid malignancy.

Park, A, Son, E, Han, K, Youk, J, Kim, J, Park, C, Shear Wave Elastography of Thyroid Nodules in a Large Scale Study: Is It a Predictor of Thyroid Malignancy?.  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/14002626.html