Thyroid nodules: shear wave elastography helps avoid repeat biopsy

  • Chen L & al.
  • Clin Endocrinol (Oxf)
  • 20/04/2019

  • Brian Richardson, PhD
  • Clinical Essentials
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Takeaway

  • Shear wave elastography (SWE) has high diagnostic performance and outperforms the thyroid imaging reporting and data system (TIRADS) category for evaluating thyroid nodules with nondiagnostic or undetermined cytology, and may help avoid repeat fine-needle aspiration cytology (FNAC).

Why this matters

  • A high percentage of patients undergoing repeat FNAC have benign nodules, necessitating other types of diagnostic tests.

Key results

  • 85.8% of nodules were benign and 14.2% were malignant.
  • Malignant nodules had higher elasticity values compared with benign nodules (mean value, 34.57 vs 19.18 kPa [P<.001 standard deviation vs kpa>
  • In receiver operating characteristic analyses, elasticity mean and standard deviation had similar area under the curve (AUC) values (0.864 vs 0.876; P=.745) but higher AUC vs TIRADS category (0.762; P=.047 and P=.012, respectively) for nodule diagnosis.
  • Elasticity mean values >24 kPa had 78.8% sensitivity and 84.9% specificity, whereas elasticity standard deviation values >5.3 kPa had sensitivity of 75.8% and specificity of 81.9%.

Study design

  • 232 thyroid nodules, 132 with nondiagnostic cytology and 100 with undetermined cytology, were analyzed by ultrasound (US) and SWE, followed by repeat US-guided FNAC, with final diagnosis based on cytology or pathology.
  • Funding: None disclosed.

Limitations

  • Single-center, retrospective study.
  • 60.3% of nodules did not have histological analysis.