ARFI elastography for differentiating malignant and benign thyroid nodules

Gülen Demirpolat; Lale Tuna; Gulgun Kavukcu; Yeşim Ertan; Serpil Paksoy; Celalettin Çevik

doi:10.19161/etd.1167252

TR EN

Malign ve benign tiroid nodüllerinin ayrımında ARFI elastografi

Öz

Amaç: Malign ve benign tiroid nodüllerini ayırd etmede “Acoustic Radiation Force Impulse” (ARFİ) elastografinin “virtual touch tissue elastografi” (VTE) modunun tanısal performansını değerlendirmek Gereç ve Yöntem: Çapı > 5 mm olan iki yüz dört adet solid ve ağırlıklı solid nodül prospektif olarak ultrasonografi, ARFI elastografinin VTQ modu, ince iğne aspirasyon biyopsisi ve endike olduğunda doku patolojisi ile değerlendirildi. Yüz doksan altı nodülde üç makaslama dalgası hızı (shear wave velocity-SWV) ölçümü yapıldı. Her bir nodül için SWV oranı, nodülün SWV'sinin ortalama değerinin komşu parankimin ortalama değerine bölünmesiyle hesaplandı. SWV değeri ve SWV oranının tanısal performansı, ROC analizi ile değerlendirildi. Bulgular: Benign ve malign tiroid nodüllerinde normal parankimdeki ortalama SWV değeri sırasıyla 2,13±0,44 m/s, 2,06±0,80 m/s ve 2,06±0,88 m/s idi. SWV oranları benign tiroid nodülleri için 0.97±0.37 ve malign tiroid nodülleri için 1.02±0.40 idi. Ortalama SWV değerleri (t=0,008) (P=0,994) veya SWV oranları (t=0,596; P=0,527) açısından benign ve malign nodüller arasında anlamlı fark yoktu. Maligniteyi öngörmek için herhangi bir cut-off noktası bulunmadı. Alt grup analizinde, SWV ve SWV oranı için AUC'ler, ˂10 mm ve ≥10 mm nodüller arasında önemli ölçüde farklıydı. Bunun dışında herhangi iki grup arasında anlamlı fark saptanmadı (tümü P>0.05). SWV ve SWV oranı için en iyi cut-off noktaları, <10 mm nodüller için sırasıyla SWV için 2.59 m/s ve SWV oranı için 1.0 idi. Sonuç: ARFİ görüntülemenin VTQ modu, maligniteyi saptamak için iyi bir tanısal performansa sahip değildir ve gereksiz tiroid biyopsilerinin azaltılmasına katkıda bulunamaz.

Anahtar Kelimeler

ARFI elastography for differentiating malignant and benign thyroid nodules

Abstract

Aim: To examine the diagnostic performance of virtual touch tissue quantification (VTQ) mode of Acoustic Radiation Force Impulse (ARFI) elastography imaging in differentiating benign and malignant thyroid nodules. Materials and Methods: Two hundred four solid and mostly solid nodules >5mm were prospectively evaluated with ultrasonography, VTQ mode of ARFI elastography, fine needle aspiration biopsy, and when indicated with tissue pathology. Three shear-wave velocities (SWV) measurements were done in 196 nodules. The SWV ratio for each nodule was calculated as the mean value of the SWV of the nodule divided by the mean value of the adjacent parenchyma. The diagnostic performance of SWV value and SWV-ratio were assessed by a receiver-operating characteristic (ROC) curve analysis. Results: The mean SWV value in the normal parenchyma, in benign and malign thyroid nodules, were 2.13±0.44 m/s, 2.06±0.80 m/s, and 2.06±0.88 m/s respectively. The SWV-ratios were 0.97±0.37 for benign thyroid nodules and 1.02±0.40 for malignant thyroid nodules. There was no significant difference between benign and malign nodules in terms of mean SWV values (t=0.008) (P=0.994) or SWV-ratios (t =0.596; P=0.527). No cut-off point was found to predict malignancy. In subgroup analysis, AUCs for the SWV and SWV-ratio were significantly different between nodules ˂10 mm and those ≥10 mm, but not with any other two groups (all P>0.05) (Table-2). The cutoff points for the differential diagnosis were 2.59 m/s for SWV and 1.0 for SWV- ratio respectively for nodules <10 mm. Conclusion: VTQ mode of ARFI imaging does not have a good diagnostic performance for detecting malignancy and cannot contribute to reducing unnecessary thyroid biopsies.

Keywords

References

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Details

Primary Language

English

Subjects

Health Care Administration

Journal Section

Research Article

Authors

Gülen Demirpolat ^*
0000-0002-9639-2672
Türkiye

Lale Tuna
0000-0003-4409-3459
Türkiye

Gulgun Kavukcu
0000-0001-6866-7256
Türkiye

Yeşim Ertan
0000-0002-4522-0774
Türkiye

Serpil Paksoy
0000-0002-4513-1018
Türkiye

Celalettin Çevik
0000-0002-1123-6196
Türkiye

Publication Date

September 12, 2022

Submission Date

January 18, 2022

Acceptance Date

February 22, 2022

Published in Issue

Year 2022 Volume: 61 Number: 3

DOI

https://doi.org/10.19161/etd.1167252

IZ

https://izlik.org/JA74YW62EH

Cite

RIS / Bibtex

Vancouver

1.Gülen Demirpolat, Lale Tuna, Gulgun Kavukcu, Yeşim Ertan, Serpil Paksoy, Celalettin Çevik. ARFI elastography for differentiating malignant and benign thyroid nodules. EJM. 2022 Sep. 1;61(3):350-9. doi:10.19161/etd.1167252