Differential diagnosis of thyroid nodules with US elastography using carotid artery pulsation.
OBJECTIVE
To explore the sensitivity and specificity of ultrasonographic (US) elastography using carotid arterial pulsation as the compression source for differential diagnosis of thyroid nodules.


METHODS
This HIPAA-compliant study was approved by the ethics committee of the institution, and all patients provided written informed consent. Fifty-eight patients (13 men and 45 women [mean age, 51 years; range, 20-76 years]) were enrolled. A short US examination and elastography with pulsation of the carotid artery used as the thyroid compression source were performed before fine-needle aspiration. Baseband US data were downloaded for off-line analysis. Elastographic maps and the thyroid stiffness index were calculated. The Kruskal-Wallis nonparametric rank sum test was used to assess equality of population medians among the different types of thyroid nodules; the R software environment was used for statistical computing and graphics (http://www.r-project.org/).


RESULTS
Thyroid stiffness index calculated with elastography using carotid arterial pulsation as the compression source was effective in helping distinguish between papillary carcinomas (n = 10) and other lesions (n = 43) because papillary carcinomas were stiffer than other lesions (P < .0039).


CONCLUSIONS
It is possible to distinguish between papillary carcinomas and other lesions with the thyroid stiffness index calculated from US elastography using carotid arterial pulsation.
Department of Radiology, University of Washington Medical Center, Seattle, WA 98195, USA. dighe@u.washington.edu
Manjiri
M
Dighe
Unmin
U
Bae
Michael L
ML
Richardson
Theodore J
TJ
Dubinsky
Satoshi
S
Minoshima
Yongmin
Y
Kim
D000328:Adult; D000368:Aged; D044963:Biopsy, Fine-Needle; D002291:Carcinoma, Papillary / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D002339:Carotid Arteries / Q000503:physiopathology*; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D011673:Pulsatile Flow; D012680:Sensitivity and Specificity; D018709:Statistics, Nonparametric; D016606:Thyroid Nodule / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D014463:Ultrasonography