Maximal Stiffness Evaluation by Real-Time Ultrasound Elastography,an Improved Tool for the Differential Diagnosis of Thyroid Nodules |
| |
| Institution: | 1. From the Unit of Internal Medicine and Endocrinology, IRCCS Fondazione Salvatore Maugeri, Department of Internal Medicine and Medical Therapy, University of Pavia, Italy;2. Laboratorio di Informatica e Sistemistica per la Ricerca Clinica, IRCCS Fondazione S. Maugeri, Pavia, Italy;3. Laboratorio di Informatica Biomedica, Dipartimento di Ingegneria Industriale e dell''Informazione Università di Pavia.;1. From the IU School of Medicine, Department of Medicine, Inpatient Medicine, Indiana University Health Physicians, Indianapolis, Indiana;2. Methodist Research Institute, Indiana University Health, IU School of Medicine, Department of Medicine, Indianapolis, Indiana.;1. From the Division of Surgical Oncology and Endocrine Surgery, Vanderbilt University, Nashville, Tennessee;2. Department of Medicine, Stanford University, Palo Alto, California;3. Department of Medicine, Eastern Virginia Medical School, Norfolk, Virginia;4. Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York;5. Department of Otolaryngology, Massachusetts General Hospital, Boston, Massachusetts.;1. From the Chair; Chairman, Grunberger Diabetes Institute; Clinical Professor, Internal Medicine and Molecular Medicine & Genetics, Wayne State University School of Medicine; Professor, Medicine, Oakland University William Beaumont School of Medicince.;2. Director, AMCR Institute; Clinical Associate Professor, USCD School of Medicine.;3. Professor of Medicine, Loyola University Medical Center; Director, Loyola University Osteoporosis and Metabolic Bone Disease Center, Maywood, IL.;4. Immediate Past President, American College of Endocrinology; Past President, American Association of Clinical Endocrinologists; Medical Director, Scripps Whittier Diabetes Institute; Clinical Professor of Medicine, University of California, San Diego; Associate Editor, Journal of Diabetes; President, Diabetes and Endocrine Associates, La Jolla, CA.;5. Professor, Departments of Medicine, Biochemistry, Molecular and Cellular Biology, Baylor College of Medicine, Houston, TX.;6. Medical Director & Principal Investigator, Metabolic Institute of America; President Elect, American College of Endocrinology.;7. Clinical Assistant Professor, Nova Southeastern University School of Osteopathic Medicine, Davie, FL.;8. Clinical Professor of Medicine, George Washington University, Alexandria, VA.;9. Professor of Medicine, Chief, Section of Endocrinology, Univeristy of Tennessee Graduate School of Medicine of Knoxville; Past President, American Association of Clinical Endocrinologists; Past President, American College of Endocrinology.;10. Managing Partner, North Texas Endocrine Center, Dallas, TX.;11. Endocrinology Associates, Houston, TX. |
| |
| Abstract: | Objective: The aim of the study was to evaluate the diagnostic performance of a new ultrasound elastography (USE) parameter based on the measurement of the percentage of maximal stiffness within a nodule as compared with the already established elastographic strain index (SI) and to investigate their diagnostic performance according to nodule size.Methods: The study included 218 nodules. Each nodule underwent conventional ultrasound (US), USE evaluation, and fine-needle aspiration cytology (FNAC). Thyroid nodules were further stratified into 4 subgroups (G) according to their size (G1, <1 cm; G2, 1–2 cm; G3, >3 cm). USE evaluation comprised the measurement of the percentage of the areas included in the region of interest corresponding to the maximal stiffness (% Index) and of the SI.Results: The % Index and of the SI were significantly higher in malignant than in benign thyroid nodules, and both measurements displayed a good diagnostic performance (SI sensitivity and specificity, 0.66 and 0.90, respectively; % Index sensitivity and specificity, 0.76 and 0.89, respectively). Compared with SI, the % Index was more informative, both in the whole group of thyroid nodules (odds ratio OR], 18.68; 95% confidence interval CI], 6.06 to 63.49; P<.0001 versus OR, 26.15; 95% CI, 8.01 to 102.87; P<.0001, respectively) and in the G1 and G2 subgroups.Conclusion: The % Index is a stronger predictor of nodule malignancy than both the SI and the conventional US signs. This is particularly true in nodules smaller than 1 cm, which are more difficult to explore both by conventional US and FNAC.Abbreviations: FNAC = fine-needle aspiration cytology % Index = percentage of maximal stiffness within the nodule MCC = Matthew's correlation coefficient OR = odds ratio RTE = real-time elastography SI = strain index US = ultrasound USE = ultrasound elastography |
| |
| Keywords: | |
| 本文献已被 ScienceDirect 等数据库收录！ |
|
