PURPOSE:  To evaluate the diagnostic performance of strain ratio elastography (SRE) and shear wave elastography (SWE) alone and in combination with Thyroid Imaging Reporting and Data System (TIRADS) classification parameters to improve differentiation between benign and malignant thyroid nodules. MATERIALS AND METHODS:  In this prospective study benign (n = 191) and malignant (n = 52) thyroid nodules were examined with high-resolution ultrasound (US) features using the TIRADS lexicon and SRE semiquantitative and SWE quantitative findings using histology or cytology as the gold standard with a 12-month follow-up. Sensitivity (Se), specificity (Sp) and the area under the ROC curve (AUROC) were used to evaluate the diagnostic performance of each feature and combinations of the methods. RESULTS:  TIRADS score showed a sensitivity of 59.6 %, a specificity of 83.8 % with an AUROC of 0.717, a PPV of 50.0 % and an NPV of 88.4 %. SRE yielded the highest performance with a sensitivity of 82.7 %, a specificity of 92.7 % with AUROC of 0.877, a PPV 75.4 % and an NPV of 95.2 %. SWE (kPa) had a sensitivity and specificity of 67.3 % and 82.7 %, respectively, with an AUROC of 0.750, a PPV of 51.5 % and an NPV of 90.3 %. Differences were significant for SRE only but not for SWE. CONCLUSION:  Ultrasound elastography may improve thyroid nodule discrimination. In particular, SRE has a better performance than TIRADS classification, while their combination improves sensitivity.

Prospective evaluation of semiquantitative strain ratio and quantitative 2D ultrasound shear wave elastography (SWE) in association with TIRADS classification for thyroid nodule characterization / Cantisani, Vito; David, Emanuele; Grazhdani, Hektor; Rubini, Antonello; Radzina, Maija; Dietrich, Christoph F; Durante, Cosimo; Lamartina, Livia; Grani, Giorgio; Ascoli, Valeria; Bosco, Daniela; Di Gioia, Cira; Frattaroli, Fabrizio Maria; D'Andrea, Vito; De Vito, Corrado; Fresilli, Daniele; D'Ambrosio, Ferdinando; Giacomelli, Laura; Catalano, Carlo. - 40:4(2019), pp. 495-503. [10.1055/a-0853-1821]

Prospective evaluation of semiquantitative strain ratio and quantitative 2D ultrasound shear wave elastography (SWE) in association with TIRADS classification for thyroid nodule characterization

Cantisani, Vito
Primo
;
David, Emanuele
Secondo
;
Rubini, Antonello;Durante, Cosimo;Lamartina, Livia;Grani, Giorgio;Valeria, Ascoli;Bosco, Daniela;Di Gioia, Cira;Frattaroli, Fabrizio Maria;D'Andrea, Vito;De Vito, Corrado;Fresilli, Daniele;D'Ambrosio, Ferdinando;Giacomelli, Laura
Penultimo
;
Catalano, Carlo
Ultimo
2019

Abstract

PURPOSE:  To evaluate the diagnostic performance of strain ratio elastography (SRE) and shear wave elastography (SWE) alone and in combination with Thyroid Imaging Reporting and Data System (TIRADS) classification parameters to improve differentiation between benign and malignant thyroid nodules. MATERIALS AND METHODS:  In this prospective study benign (n = 191) and malignant (n = 52) thyroid nodules were examined with high-resolution ultrasound (US) features using the TIRADS lexicon and SRE semiquantitative and SWE quantitative findings using histology or cytology as the gold standard with a 12-month follow-up. Sensitivity (Se), specificity (Sp) and the area under the ROC curve (AUROC) were used to evaluate the diagnostic performance of each feature and combinations of the methods. RESULTS:  TIRADS score showed a sensitivity of 59.6 %, a specificity of 83.8 % with an AUROC of 0.717, a PPV of 50.0 % and an NPV of 88.4 %. SRE yielded the highest performance with a sensitivity of 82.7 %, a specificity of 92.7 % with AUROC of 0.877, a PPV 75.4 % and an NPV of 95.2 %. SWE (kPa) had a sensitivity and specificity of 67.3 % and 82.7 %, respectively, with an AUROC of 0.750, a PPV of 51.5 % and an NPV of 90.3 %. Differences were significant for SRE only but not for SWE. CONCLUSION:  Ultrasound elastography may improve thyroid nodule discrimination. In particular, SRE has a better performance than TIRADS classification, while their combination improves sensitivity.
2019
ZIEL DER STUDIE:  Die Studie erfolgte, um die diagnostische Genauigkeit der Kompressionselastografie (SRE) und Scherwellenelastografie (SWE) einzeln und in Kombination mit der Thyroid-Imaging-Reporting-and-Data-System (TIRADS)-Klassifikation zu untersuchen, um eine verbesserte Differenzierung von benignen und malignen Schilddrüsenknoten zu ermöglichen. PATIENTEN UND METHODEN:  In dieser prospektiven Studie wurden gutartige (n = 191) und bösartige (n = 52) Schilddrüsenknoten mittels Ultraschall, SRE und SWE untersucht und die Daten mit der TIRADS-Klassifikation verglichen. Gutartige Läsionen wurden 12 Monate nachbeobachtet. Sensitivität (Se), Spezifität (Sp) und der Bereich unter der ROC-Kurve (Area-under-the-ROC-Curve – AUROC) sowie der positive prädiktive (PPV) und der negative prädiktive Wert (NPV) wurden berechnet, um die diagnostische Genauigkeit der einzelnen und kombinierten Methoden zu vergleichen. ERGEBNISSE:  Der TIRADS-Score zeigte eine Se von 59,6 % und eine Sp von 83,8 % mit einer AUROC von 0,717. Der PPV lag bei 50,0 % und der NPV bei 88,4 %. SRE (in Klammern SWE (kPa)) erreichte die höchste Genauigkeit mit einer Se von 82,7 % (67,3 %) und einer Sp von 92,7 % (82,7 %); die AUROC lag bei 0,877 (0,750). Die Unterschiede zwischen SRE und SWE waren statistisch signifikant (p < 0,05). SCHLUSSFOLGERUNG:  Die Ultraschallelastografie kann eine verbesserte Differenzierung von Schilddrüsenknoten ermöglichen. Insbesondere zeigt SRE bessere Ergebnisse als TIRADS, während die kombinierte Anwendung die Sensitivität verbessert.
thyroid nodule characterization; TIRADS; elastography
01 Pubblicazione su rivista::01a Articolo in rivista
Prospective evaluation of semiquantitative strain ratio and quantitative 2D ultrasound shear wave elastography (SWE) in association with TIRADS classification for thyroid nodule characterization / Cantisani, Vito; David, Emanuele; Grazhdani, Hektor; Rubini, Antonello; Radzina, Maija; Dietrich, Christoph F; Durante, Cosimo; Lamartina, Livia; Grani, Giorgio; Ascoli, Valeria; Bosco, Daniela; Di Gioia, Cira; Frattaroli, Fabrizio Maria; D'Andrea, Vito; De Vito, Corrado; Fresilli, Daniele; D'Ambrosio, Ferdinando; Giacomelli, Laura; Catalano, Carlo. - 40:4(2019), pp. 495-503. [10.1055/a-0853-1821]
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11573/1276192
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