Application of sonoelastography in differential diagnosis of benign and malignant thyroid nodules
Fatemeh Esfahanian1, Arvin Aryan2, Mahsa Ghajarzadeh3, Meisam Hosein Yazdi4, Nasir Nobakht4, Mehdi Burchi4
1 Department of Endocrinology, Imam Khomeini Hospital, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
2 Department of Radiology, Medical Imaging Center, Advanced Diagnostic and Interventional Radiology Research Center, Imam Hospital, Tehran University of Medical Sciences, Tehran, Iran
3 Brain and Spinal Injury Research Center, Tehran University of Medical Sciences, Tehran, Iran
4 Department of Internal Medicine, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
Department of Radiology, Medical Imaging Center, Advanced Diagnostic and Interventional Radiology Research Center, Imam Khomeini Hospital, Tehran
Source of Support: None, Conflict of Interest: None
Background: Sonoelastography is a new ultrasound method which could be helpful to determine which thyroid nodule is malignant. We designed this study to evaluate the accuracy of sonoelastography in differentiating of benign and malignant thyroid nodules in Iranian patients.
Methods: Forty thyroid nodules in forty consecutive patients who had been referred for sonography-guided fine-needle aspiration biopsy were evaluated. Gray scale ultrasound and elastosonography by real-time, freehand technique applied for all patients. Elastography findings were classified into four groups. Nodules which were classified as patterns 1 or 2 in elastogram evaluation were classified as benign and probably malignant if elastogram scans were patterns 3 and 4 of elastogram scan.
Results: Mean age ± standard deviation (SD) was 42.2 ± 12.6 years, and mean ± SD thyroid-stimulating hormone level was 1.4 ± 1.9 IU/ml. Thirty-five cases (87.5%) were female and 5 (12.5%) were male. Histological examination indicated 27 (67.5%) benign and 13 (32.5%) malignant nodules. The most elastogram score was 2 (50%) followed by score 3. The cut-off point of 2 considered as the best value to differentiate benign and malignant thyroid nodules with sensitivity and specificity of 61% and 78% (area under the curve = 0.76, 95% confidence interval: 0.6-0.92, P = 0.007).
Conclusions: Sonoelastography could help to differentiate benign and malignant thyroid nodules. As our sample size was limited, larger studies are recommended.