title: Prospective evaluation of multiparametric ultrasound and quantitative elastosonography in the differential diagnosis of benign and malignant thyroid nodules: preliminary experience.
abstract: OBJECTIVE
  To assess the clinical value of quantitative elastosonography compared with multiparametric ultrasound in differentiating the nature of thyroid nodules.
  
  
  METHODS
  Ninety-seven consecutive patients (32 males, 65 females, mean age, 54 years, range 20-81 years) with thyroid nodules previously detected at color-Doppler ultrasound (CDUS), were prospectively examined with elastosonography with dedicated quantitative software (Elasto-Q, Toshiba) before surgery. Ultrasound examination and elastosonography were evaluated by two investigators in consensus. US features, color-Doppler pattern, and strain ratio value were evaluated. Sensitivity and specificity of CDUS and sono-elastography were compared using X(2) test and ROC curves.
  
  
  RESULTS
  Sensitivity and specificity of hypoechogenicity, irregular margins or suspicious halo features, CDUS blood flow pattern, and strain ratio in the diagnosis of malignant nodules were 56.8%, 62.2%, 54.1% and 97.3% and 71.7%, 93.3%, 28.3%, and 91.7%, respectively. Elastosonography was more sensitive and specific than all ultrasonographic features in predicting malignancy of the thyroid nodules (p<0.0001). According to elastosonographic features the lesions characterized by strain ratio ≥ 2 were highly likely to be of malignant nature (p<0.0001, O.R. 396, 95%, CI: 44-3530).
  
  
  CONCLUSIONS
  The results of the present study suggest that elastosonography with Q system is a valuable tool in the characterization of thyroid nodules and it seems to be far more accurate than CDUS. These findings as well as those of previous studies support its use in selecting patients who are candidates for surgery.
authors.affiliation: Department of Radiology, Oncology, and Anatomy Pathology, University "La Sapienza", Policlinico Umberto I, Rome, Itlay. vito.cantisani@uniroma1.it
authors.forename: Vito
authors.initials: V
authors.lastname: Cantisani
authors.forename: Vito
authors.initials: V
authors.lastname: D'Andrea
authors.forename: Fausto
authors.initials: F
authors.lastname: Biancari
authors.forename: Olena
authors.initials: O
authors.lastname: Medvedyeva
authors.forename: Mattia
authors.initials: M
authors.lastname: Di Segni
authors.forename: Matteo
authors.initials: M
authors.lastname: Olive
authors.forename: Gregorio
authors.initials: G
authors.lastname: Patrizi
authors.forename: Adriano
authors.initials: A
authors.lastname: Redler
authors.forename: Enrico
authors.initials: E
authors.lastname: De Antoni E
authors.forename: Raffaele
authors.initials: R
authors.lastname: Masciangelo
authors.forename: Francesca
authors.initials: F
authors.lastname: Frezzotti
authors.forename: Paolo
authors.initials: P
authors.lastname: Ricci
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000465:Algorithms; D003937:Diagnosis, Differential; D054459:Elasticity Imaging Techniques / Q000379:methods*; D005260:Female; D006801:Humans; D007089:Image Enhancement / Q000379:methods; D007090:Image Interpretation, Computer-Assisted / Q000379:methods*; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D010865:Pilot Projects; D011446:Prospective Studies; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D016606:Thyroid Nodule / Q000000981:diagnostic imaging*