title: Q-elastosonography of solid thyroid nodules: assessment of diagnostic efficacy and interobserver variability in a large patient cohort.
abstract: OBJECTIVE
  Evaluation of the diagnostic efficacy and interobserver agreement of Q-elastography in the differentiation of benign from malignant thyroid nodules.
  
  
  METHODS
  A total of 344 thyroid nodules in 288 patients were examined with grey-scale and colour Doppler ultrasound (CDUS) and Q-elastography by two independent operators. Nodules with hypoechogenicity, poorly defined margins, microcalcifications, and intralesional vascularity were classified as suspicious. Diagnostic performances of CDUS features and Q-elastography for predicting thyroid malignancy were estimated using ROC analysis. Cytology or histopathology was the reference standard. Interobserver agreement in the evaluation of CDUS and Q-elastography was assessed using Cohen's k-statistic.
  
  
  RESULTS
  Q-elastography showed excellent diagnostic performance for the prediction of thyroid malignancy, with sensitivity of 93 % and specificity of 92 % for operator 1 (best cutoff at 2.02), and sensitivity of 84 % and specificity of 79 % for operator 2 (best cutoff at 1.86). Performance of Q-elastography was superior to that of CDUS. Reproducibility of the findings was excellent for both Q-elastography and CDUS features as assessed with Cohen's k, which was highest for strain ratio measurements (0.95) and lowest for the echogenicity score (0.83).
  
  
  CONCLUSIONS
  Q-elastography showed excellent performance. It is a valid and reproducible diagnostic method as well as a promising tool for identifying suspicious solid thyroid nodules needing cytological assessment and surgery.
  
  
  CONCLUSIONS
  • Elastography is an additional tool for optimal characterisation of malignant thyroid nodules. • The use of semiquantitative elastographic evaluation increases the diagnostic performance, • The interobserver agreement of quantitative elastography can be considered to be good.
authors: Department of Radiology, Oncology, and Anatomy Pathology, University "La Sapienza", Policlinico Umberto I, Viale del Policlinico 155, 00161, Rome, Italy, vito.cantisani@uniroma1.it.
authors: Vito
authors: V
authors: Cantisani
authors: Hektor
authors: H
authors: Grazhdani
authors: Paolo
authors: P
authors: Ricci
authors: Koenraad
authors: K
authors: Mortele
authors: Mattia
authors: M
authors: Di Segni
authors: Vito
authors: V
authors: D'Andrea
authors: Adriano
authors: A
authors: Redler
authors: Giorgio
authors: G
authors: Di Rocco
authors: Laura
authors: L
authors: Giacomelli
authors: Elena
authors: E
authors: Maggini
authors: Carlo
authors: C
authors: Chiesa
authors: Sukru Mehmet
authors: SM
authors: Erturk
authors: Salvatore
authors: S
authors: Sorrenti
authors: Carlo
authors: C
authors: Catalano
authors: Ferdinando
authors: F
authors: D'Ambrosio
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002114:Calcinosis / Q000000981:diagnostic imaging*; D003937:Diagnosis, Differential; D054459:Elasticity Imaging Techniques / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012372:ROC Curve; D015203:Reproducibility of Results; D016606:Thyroid Nodule / Q000000981:diagnostic imaging*; D018615:Ultrasonography, Doppler, Color / Q000379:methods; D055815:Young Adult
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