Purpose: To assess Strain Ratio (SRE) and Shear Wave Elastography (SWE) accuracy alone and with TIRADS classification, for the risk stratification of indeterminate thyroid nodules. Materials and methods: 128 Patients with 128 indeterminate nodules candidates for thyroidectomy underwent preoperative staging neck ultrasound and were classified according to K-TIRADS score. After TIRADS evaluation, semi-quantitative (SRE) and quantitative (SWE expressed in kPa) elastosonography were performed and relative diagnostic performances, alone and in combination, were compared through ROC curves analysis. In order to maximize the SRE and SWE sensitivity and specificity, their cut-off values were calculated using the Liu test. Bonferroni test was used to evaluate statistically significant differences with a p value < 0.05. Results: Sensitivity, specificity, PPV and NPV were, respectively, 71.4%, 82.4%, 62.5%, 87.5% for K-TIRADS baseline US, 85.7%, 94.1%, 85.7%, 94.1% for SRE and 57.1%, 79.4%, 53.3%, 81.8% for SWE (kPa expressed). SRE evaluation showed the best diagnostic accuracy compared to the SWE (kPa expressed) (p < 0.05) and to the K-TIRADS (p > 0.05). The association of SRE with conventional ultrasound with K-TIRADS score increased sensitivity (92.9% vs 71.4%) but decreased the specificity than conventional US alone (76.5% vs 82.4%). Conclusion: Strain Elastosonography can be associated with K-TIRADS US examination in the thyroid nodule characterization with indeterminate cytology; in fact, adding the SRE to K-TIRADS assessment significantly increases its sensitivity and negative predictive value. However, further multicenter studies on larger population are warranted.

TIRADS, SRE and SWE in INDETERMINATE thyroid nodule characterization: which has better diagnostic performance? / Celletti, Ilaria; Fresilli, Daniele; De Vito, Corrado; Bononi, Marco; Cardaccio, Sara; Cozzolino, Alessia; Durante, Cosimo; Grani, Giorgio; Grimaldi, Gianmarco; Isidori, Andrea M; Catalano, Carlo; Cantisani, Vito. - In: LA RADIOLOGIA MEDICA. - ISSN 0033-8362. - 126:9(2021), pp. 1189-1200. [10.1007/s11547-021-01349-5]

TIRADS, SRE and SWE in INDETERMINATE thyroid nodule characterization: which has better diagnostic performance?

Celletti, Ilaria
Primo
;
Fresilli, Daniele
Secondo
;
De Vito, Corrado;Bononi, Marco;Cardaccio, Sara;Cozzolino, Alessia;Durante, Cosimo;Grani, Giorgio;Grimaldi, Gianmarco;Isidori, Andrea M;Catalano, Carlo
Penultimo
;
Cantisani, Vito
Ultimo
2021

Abstract

Purpose: To assess Strain Ratio (SRE) and Shear Wave Elastography (SWE) accuracy alone and with TIRADS classification, for the risk stratification of indeterminate thyroid nodules. Materials and methods: 128 Patients with 128 indeterminate nodules candidates for thyroidectomy underwent preoperative staging neck ultrasound and were classified according to K-TIRADS score. After TIRADS evaluation, semi-quantitative (SRE) and quantitative (SWE expressed in kPa) elastosonography were performed and relative diagnostic performances, alone and in combination, were compared through ROC curves analysis. In order to maximize the SRE and SWE sensitivity and specificity, their cut-off values were calculated using the Liu test. Bonferroni test was used to evaluate statistically significant differences with a p value < 0.05. Results: Sensitivity, specificity, PPV and NPV were, respectively, 71.4%, 82.4%, 62.5%, 87.5% for K-TIRADS baseline US, 85.7%, 94.1%, 85.7%, 94.1% for SRE and 57.1%, 79.4%, 53.3%, 81.8% for SWE (kPa expressed). SRE evaluation showed the best diagnostic accuracy compared to the SWE (kPa expressed) (p < 0.05) and to the K-TIRADS (p > 0.05). The association of SRE with conventional ultrasound with K-TIRADS score increased sensitivity (92.9% vs 71.4%) but decreased the specificity than conventional US alone (76.5% vs 82.4%). Conclusion: Strain Elastosonography can be associated with K-TIRADS US examination in the thyroid nodule characterization with indeterminate cytology; in fact, adding the SRE to K-TIRADS assessment significantly increases its sensitivity and negative predictive value. However, further multicenter studies on larger population are warranted.
2021
elastosonography; shear-wave elastography; strain-ratio elastography; TIRADS; thyroid nodule
01 Pubblicazione su rivista::01a Articolo in rivista
TIRADS, SRE and SWE in INDETERMINATE thyroid nodule characterization: which has better diagnostic performance? / Celletti, Ilaria; Fresilli, Daniele; De Vito, Corrado; Bononi, Marco; Cardaccio, Sara; Cozzolino, Alessia; Durante, Cosimo; Grani, Giorgio; Grimaldi, Gianmarco; Isidori, Andrea M; Catalano, Carlo; Cantisani, Vito. - In: LA RADIOLOGIA MEDICA. - ISSN 0033-8362. - 126:9(2021), pp. 1189-1200. [10.1007/s11547-021-01349-5]
File allegati a questo prodotto
File Dimensione Formato  
Celletti_TIRADS_2021.pdf

accesso aperto

Note: Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.
Tipologia: Versione editoriale (versione pubblicata con il layout dell'editore)
Licenza: Creative commons
Dimensione 1.3 MB
Formato Adobe PDF
1.3 MB Adobe PDF

I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.

Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11573/1553356
Citazioni
  • ???jsp.display-item.citation.pmc??? 22
  • Scopus 27
  • ???jsp.display-item.citation.isi??? 29
social impact