Combined value of Virtual Touch tissue quantification and conventional sonographic features for differentiating benign and malignant thyroid nodules smaller than 10 mm.
OBJECTIVE
This study aimed to investigate the value of sonographic features including Virtual Touch tissue quantification (VTQ; Siemens Medical Solutions, Mountain View, CA) for differentiating benign and malignant thyroid nodules smaller than 10 mm.


METHODS
Seventy-one thyroid nodules smaller than 10 mm with pathologic diagnoses were included in this study. The conventional sonographic features and quantitative elasticity features (VTQ) were observed and compared between benign and malignant nodules.


RESULTS
There were 39 benign and 32 malignant nodules according to histopathologic examination. When compared with benign nodules, malignant nodules were more frequently taller than wide, poorly defined, and markedly hypoechoic (P < .05). Color Doppler sonographic features were not significantly different between benign and malignant nodules. The VTQ value for malignant nodules (mean ± SD 3.260 ± 0.725 m/s) was significantly higher than that of benign ones (2.108 ± 0.455 m/s; P < .001). The cutoff point for the differential diagnosis was 2.910 m/s, with sensitivity, specificity, a positive predictive value, a negative predictive value, and diagnostic accuracy of 71.9%, 100%, 100%, 81.2%, and 87.3% respectively. Logistic regression analysis showed that a taller-than-wide shape, a poorly defined boundary, marked hypoechogenicity, and a VTQ value greater than 2.910 m/s were independent risk factors for malignancy, with odds ratios of 69.366, 41.864, 5.945, and 64.991. The combination of VTQ with a taller-than-wide shape had the highest sensitivity and specificity of 90.6% and 97.4%.


CONCLUSIONS
The shape, margin, echogenicity, and VTQ value are useful sonographic criteria for differentiating benign and malignant thyroid nodules smaller than 10 mm. When VTQ was combined with B-mode sonographic features, the sensitivity was improved significantly.
Department of Ultrasound, First People's Hospital Shanghai Jiaotong University, 85 Wujin Rd, 200080 Shanghai, China. du_lf@163.com.
Huiping
H
Zhang
Qiusheng
Q
Shi
Jiying
J
Gu
Luying
L
Jiang
Min
M
Bai
Long
L
Liu
Ying
Y
Wu
Lianfang
L
Du
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; D010173:Palpation / Q000379:methods*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D016606:Thyroid Nodule / Q000145:classification / Q000000981:diagnostic imaging*; D014584:User-Computer Interface
Virtual Touch tissue quantification; general ultrasound; small thyroid nodules; sonography