title: Comparison of diagnostic value of conventional ultrasonography and shear wave elastography in the prediction of thyroid lesions malignancy.
abstract: BACKGROUND
  Thyroid nodular disease (TND) is a very common disorder. However, since the rate of malignancy is reported to be 3-10%, only a minority of patients require aggressive surgical treatment. As a result, there is a need for diagnostic tools which would allow for a reliable differentiation between benign and malignant nodules. Although a number of conventional ultrasonographic (US) features are proved to be markers of malignancy, Shear Wave Elastography (SWE) is considered to be an improvement of conventional US. The aim of this study was to compare conventional US markers and SWE diagnostic values in the differentiation of benign and malignant thyroid nodules.
  
  
  METHODS
  All patients referred for thyroidectomy, irrespective of the indications, underwent a US thyroid examination prospectively. Patients with TND were included into the study. Results of the US and SWE examinations were compared with post-surgical histopathology.
  
  
  RESULTS
  One hundred and twenty two patients with 393 thyroid nodules were included into the study. Twenty two patients were diagnosed with cancer. SWE turned out to be a predictor of malignancy superior to any other conventional US markers (OR=54.5 using qualitative scales and 40.8 using quantitative data on maximal stiffness with a threshold of 50 kPa).
  
  
  CONCLUSIONS
  Although most conventional US markers of malignancy prove to be significant, none of them are characterized by both high sensitivity and specificity. SWE seems to be an important step forward, allowing for a more reliable distinction of benign and malignant thyroid nodules. Our study, assessing SWE properties on the highest number of thyroid lesions at the time of publication, confirms the high diagnostic value of this technique. It also indicates that a quantitative evaluation of thyroid lesions is not superior to simpler qualitative methods.
authors: Department of Endocrinology, Metabolism and Internal Medicine, Karol Marcinkowski University of Medical Sciences, Poznan, Poland.
authors: Ewelina
authors: E
authors: Szczepanek-Parulska
authors: Kosma
authors: K
authors: Woliński
authors: Adam
authors: A
authors: Stangierski
authors: Edyta
authors: E
authors: Gurgul
authors: Maciej
authors: M
authors: Biczysko
authors: Przemysław
authors: P
authors: Majewski
authors: Magdalena
authors: M
authors: Rewaj-Łosyk
authors: Marek
authors: M
authors: Ruchała
mesh_terms: D000328:Adult; D000368:Aged; D001775:Blood Circulation; D004548:Elasticity; D054459:Elasticity Imaging Techniques / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012680:Sensitivity and Specificity; D013964:Thyroid Neoplasms / Q000000981:diagnostic imaging* / Q000503:physiopathology / Q000601:surgery; D055815:Young Adult