title: Q-elastography in the presurgical diagnosis of thyroid nodules with indeterminate cytology.
abstract: Quantitative ultrasound (US) elastography (Q-USE), able to evaluate tissue stiffness has been indicated as a new diagnostic tool to differentiate benign from malignant thyroid lesions. Aim of this prospective study, conducted at the Department of Surgical Sciences, of the "Sapienza" University of Rome, was to evaluate the diagnostic accuracy of Q-USE, compared with US parameters, in thyroid nodules with indeterminate cytology (Thy3).The case study included 140 nodules from 140 consecutive patients. Patient's thyroid nodules were evaluated by Q-USE, measuring the strain ratio (SR) of stiffness between nodular and surrounding normal thyroid tissue, and conventional US parameters prior fine-needle aspiration cytology. Those with Thy3 diagnosis were included in the study. Forty of the nodules analyzed harbored a malignant lesion. Q-USE demonstrated that malignant nodules have a significant higher stiffness with respect to benign one and an optimun SR cut-off value of 2.05 was individuated following ROC analysis. Univariate analysis showed that hypoechogenicity, irregular margins and SR >2.05 associated with malignancy, with an accuracy of 67.2%, 81,0% and 89.8%, respectively. Data were unaffected by nodule size or thyroiditis. These findings were confirmed in multivariate analysis demonstrating a significant association of the SR and the irregular margins with thyroid nodule's malignancy. In conclusion, we demonstrated the diagnostic utility of Q-USE in the differential diagnosis of thyroid nodules with indeterminate cytology that, if confirmed, could be of major clinical utility in patients' presurgical selection.
authors.affiliation: Department of Radiology, Oncology and Antomy Pathology, Sapienza University of Rome, Rome, Italy.
authors.forename: Vito
authors.initials: V
authors.lastname: Cantisani
authors.forename: Salvatore
authors.initials: S
authors.lastname: Ulisse
authors.forename: Eleonora
authors.initials: E
authors.lastname: Guaitoli
authors.forename: Corrado
authors.initials: C
authors.lastname: De Vito
authors.forename: Riccardo
authors.initials: R
authors.lastname: Caruso
authors.forename: Renzo
authors.initials: R
authors.lastname: Mocini
authors.forename: Vito
authors.initials: V
authors.lastname: D'Andrea
authors.forename: Valeria
authors.initials: V
authors.lastname: Ascoli
authors.forename: Alfredo
authors.initials: A
authors.lastname: Antonaci
authors.forename: Carlo
authors.initials: C
authors.lastname: Catalano
authors.forename: Francesco
authors.initials: F
authors.lastname: Nardi
authors.forename: Adriano
authors.initials: A
authors.lastname: Redler
authors.forename: Paolo
authors.initials: P
authors.lastname: Ricci
authors.forename: Enrico
authors.initials: E
authors.lastname: De Antoni
authors.forename: Salvatore
authors.initials: S
authors.lastname: Sorrenti
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D044963:Biopsy, Fine-Needle; D054459:Elasticity Imaging Techniques / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016606:Thyroid Nodule / Q000175:diagnosis* / Q000000981:diagnostic imaging*; D055815:Young Adult