US Elastography Using Carotid Artery Pulsation May Increase the Diagnostic Accuracy for Thyroid Nodules with US-Pathology Discordance

Ultrasound Med Biol. 2017 Aug;43(8):1587-1595. doi: 10.1016/j.ultrasmedbio.2017.04.007. Epub 2017 May 17.

Abstract

This study evaluated the diagnostic performance of ultrasound elastography (USE) using carotid arterial pulsation and determined the reproducibility of USE for thyroid nodules. A total of 148 patients with 173 thyroid nodules participated. The mean elasticity contrast index (ECI) was significantly higher in malignant nodules (3.1 ± 1.5) than in benign nodules (1.7 ± 0.8) (p < 0.001). When a cut-off ECI value of 3.5 was used, the diagnostic accuracy (78.6%) of gray-scale ultrasound (US) + ECI was the highest compared with that of the gray-scale US (76.9%) and ECI (67.1%). In 16 of 43 nodules (37.2%) with US-pathology, discordance could be correctly reclassified as benign (8 of 11) or malignant (8 of 32). The intra-class correlation coefficient for inter-observer agreement was 0.96, and those for intra-observer agreement were 0.97 and 0.98. Thyroid nodules with ECI values of >3.5 may have an additional value to increase the diagnostic accuracy for nodules with US-pathology discordance with reproducible results.

Keywords: Elastography; Fine-needle aspiration; Thyroid cancer; Thyroid nodule; Ultrasonography.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Carotid Arteries / physiology*
  • Diagnosis, Differential
  • Elasticity Imaging Techniques / methods*
  • Female
  • Humans
  • Image Processing, Computer-Assisted / methods*
  • Male
  • Middle Aged
  • Observer Variation
  • Prospective Studies
  • Reproducibility of Results
  • Sensitivity and Specificity
  • Thyroid Gland / diagnostic imaging
  • Thyroid Gland / pathology
  • Thyroid Nodule / diagnostic imaging*
  • Thyroid Nodule / pathology*
  • Young Adult