title: Role of ultrasound elastography in prediction of malignancy in thyroid nodules.
abstract: BACKGROUND
  Ultrasonography is considered useful to distinguish between solid and cystic thyroid nodules and to stratify a nodule's risk of cancer as low, medium, or high. Ultrasound (US) elastography has been applied to study the hardness/elasticity of nodules to differentiate malignant from benign lesions. Elastography possibly can solve the dilemma in reaching an accurate diagnosis for the cytologically known as indeterminate nodules.
  
  
  OBJECTIVE
  To evaluate the sensitivity and specificity of US elastography in the diagnosis of thyroid cancer.
  
  
  METHODS
  This prospective study included 40 patients. The total number of nodules was 46, they were all euthyroid. Laboratory investigations were done including FT3, FT4, and TSH to exclude hot nodules. Neck US, US elastography, and fine-needle aspiration were done to all patients, and US elastography scoring system from 1 to 4 was used.
  
  
  RESULTS
  Four out of the 46 studied nodules were malignant. The ROC curve for elastography score (E-score) showed high sensitivity, specificity for the diagnosis of malignant thyroid nodules with a cut-off value of E-score 4 and high significance (p<0.001), the area under curve was 0.92. The sensitivity was 75.0% and specificity was 100%. For E-score more than 2, the sensitivity was 100% and specificity was 85.37%.
  
  
  CONCLUSIONS
  US elastography can be used to increase both the sensitivity and the specificity of US for the detection of malignant thyroid nodules, and so it seems to have great potential as a new tool for the diagnosis of thyroid cancer.
authors.affiliation: Department of Internal Medicine, Faculty of Medicine, Cairo University, Cairo, Egypt.
authors.forename: Mona
authors.initials: M
authors.lastname: Mansor
authors.forename: Hussein
authors.initials: H
authors.lastname: Okasha
authors.forename: Serag
authors.initials: S
authors.lastname: Esmat
authors.forename: Ahmed Murad
authors.initials: AM
authors.lastname: Hashem
authors.forename: Khaled A
authors.initials: KA
authors.lastname: Attia
authors.forename: Hossam
authors.initials: H
authors.lastname: El-din Hussein
mesh_terms: D000293:Adolescent; D000328:Adult; D044963:Biopsy, Fine-Needle; D002114:Calcinosis / Q000000981:diagnostic imaging; D002648:Child; D054459:Elasticity Imaging Techniques; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D013964:Thyroid Neoplasms / Q000098:blood supply / Q000000981:diagnostic imaging* / Q000473:pathology*; D016606:Thyroid Nodule / Q000098:blood supply / Q000000981:diagnostic imaging* / Q000473:pathology*