Evaluation of the effectiveness of real-time elastography in the differential diagnosis of benign and malignant thyroid nodules

Lale Tuna; Gulgun Kavukcu; İlhan Hekimsoy; Özer Makay; Yeşim Ertan; Sadık Tamsel

doi:10.19161/etd.1151030

EN TR

Evaluation of the effectiveness of real-time elastography in the differential diagnosis of benign and malignant thyroid nodules

Abstract

Aim: The aim of this study was to evaluate the efficiency of real-time elastography (RTE) in the differential diagnosis of thyroid nodules. Materials and Methods: Fifty-two patients with 60 thyroid nodules were included in this study. Real-time elastography examinations were performed on the axial and longitudinal planes. Elastography images were classified between score 1 (whole nodule is soft) and score 5 (hardness in whole nodule and surrounding tissues). Nodules with scores of 1, 2 and 3 were considered benign, and nodules with scores of 4 and 5 were considered malignant. Nodule-to-sternocleidomastoid and thyroid tissue-to-nodule strain ratios (SR) were calculated. The nodules were evaluated by means of size, echogenicity, border, presence of halo and microcalcifications. Elasticity scores and mean strain ratios of all nodules were compared with the cytological or histopathological diagnosis. Results: Forty-three of all cases were benign, and seventeen were malignant. Hypoechogenicity, microcalcifications and absence of halo were statistically related but irregular margins, and a high elasticity score were not statistically related to malignancy. The diagnostic performance of strain ratio was found insignificant. Nodule echogenicity had the highest accuracy among all nodule characteristics. Conclusion: Diagnostic performance of real-time elastography in the differentiation of benign and malignant thyroid nodules is suboptimal. Real-time elastography is not an alternative to gray scale ultrasound.

Keywords

Tiroid nodüllerinin benign ve malign ayırıcı tanısında gerçek zamanlı elastografinin etkinliğinin araştırılması

Öz

Amaç: Çalışmamızın amacı tiroid nodüllerinin benign-malign ayırıcı tanısında gerçek zamanlı elastografinin (GZE) etkinliğinin araştırılmasıdır. Gereç ve yöntem: Araştırmaya 52 olgudaki 60 tiroid nodülü dahil edildi. Nodüller boyut, ekojenite, kontur özellikleri, halo ve mikrokalsifikasyon varlığı açısından değerlendirildi. Aksiyel ve longitudinal planlarda gerçek zamanlı elastografi incelemeleri gerçekleştirildi. Elastografi görüntüleri skor 1 (nodülün tamamı yumuşak) ile skor 5 arasında (nodülün tamamı ve çevre dokularda sertlik) sınıflandırıldı. Skor 1, 2 ve 3 nodüller benign, skor 4 ve 5 olan nodüller malign olarak kabul edildi. Nodül/sternokleidomastoid kası ve tiroid dokusu/nodül gerinim oranları hesaplandı. Tüm nodüllerin elastografi skorları ve ortalama gerinim oranları sitolojik ve histopatolojik tanı ile karşılaştırıldı. Bulgular: Tüm olguların 43'ü benign, 17'si maligndi. Malignite tanısında nodül ekojenitesi doğruluğu en yüksek olan özellikti. Hipoekojenite, mikrokalsifikasyon ve halo yokluğu ile malignite arasında istatistiksel olarak anlamlı ilişki saptandı. Yüksek elastisite skoru ile malignite arasında istatistiksel anlamlı ilişiki saptanmadı. Gerinim oranının diagnostik ROC eğrisi analizi önemsiz bulundu. Sonuç: Tiroid nodüllerinin benign-malign ayrımında gerçek zamanlı elastografinin tanısal performansı suboptimaldir. Gerçek zamanlı elastografi gri skala ultrasona alternatif olabilecek bir yöntem değildir.

Anahtar Kelimeler

Supporting Institution

YOKTUR

References

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Details

Primary Language

English

Subjects

Radiology and Organ Imaging

Journal Section

Research Article

Authors

Lale Tuna ^*
0000-0003-4409-3459
Türkiye

Gulgun Kavukcu
0000-0001-6866-7256
Türkiye

İlhan Hekimsoy
0000-0001-5768-1239
Türkiye

Özer Makay
0000-0002-6660-6748
Türkiye

Yeşim Ertan
0000-0002-4522-0774
Türkiye

Sadık Tamsel
0000-0001-8749-782X
Türkiye

Publication Date

June 12, 2023

Submission Date

August 19, 2022

Acceptance Date

December 5, 2022

Published in Issue

Year 1970 Volume: 62 Number: 2

DOI

https://doi.org/10.19161/etd.1151030

IZ

https://izlik.org/JA96YD29YS

Cite

RIS / Bibtex

Vancouver

1.Lale Tuna, Gulgun Kavukcu, İlhan Hekimsoy, Özer Makay, Yeşim Ertan, Sadık Tamsel. Evaluation of the effectiveness of real-time elastography in the differential diagnosis of benign and malignant thyroid nodules. EJM. 2023 Jun. 1;62(2):279-88. doi:10.19161/etd.1151030