title: Elastography can effectively decrease the number of fine-needle aspiration biopsies in patients with calcified thyroid nodules.
abstract: When calcification, frequently found in both benign and malignant nodules, is present in thyroid nodules, non-invasive differentiation with ultrasound becomes challenging. The goal of this study was to evaluate the utility of elastography in differentiating calcified thyroid nodules. Consecutive patients (165 patients with 196 nodules) referred for fine-needle aspiration who had undergone both ultrasound elastography and B-mode examinations were analyzed retrospectively. Calcification was present in 45 benign and 20 malignant nodules. On 65 calcified nodules, elastography had 95% sensitivity, 51.1% specificity, 46.3% positive predictive value and 95.8% negative predictive value in detecting malignancy. Twenty-three of 45 benign calcified nodules were correctly diagnosed with elastography compared with 4 of 45 by B-mode ultrasound. Although it is difficult to differentiate benign and malignant calcified thyroid nodules solely with B-mode ultrasound, elastography has the potential to reduce the number of fine-needle aspiration biopsies performed on calcified nodules.
authors.affiliation: Division of Endocrinology and Metabolism, Department of Internal Medicine, Catholic University of Korea, Seoul, Korea.
authors.forename: Min-Hee
authors.initials: MH
authors.lastname: Kim
authors.affiliation: Department of Electrical Engineering, University of Washington, Seattle, Washington, USA.
authors.forename: Si
authors.initials: S
authors.lastname: Luo
authors.affiliation: Division of Endocrinology and Metabolism, Department of Internal Medicine, Catholic University of Korea, Seoul, Korea.
authors.forename: Sun Hee
authors.initials: SH
authors.lastname: Ko
authors.affiliation: Department of Radiology, Catholic University of Korea, Seoul, Korea.
authors.forename: So-Lyung
authors.initials: SL
authors.lastname: Jung
authors.affiliation: Division of Endocrinology and Metabolism, Department of Internal Medicine, Catholic University of Korea, Seoul, Korea. Electronic address: ldj6026@catholic.ac.kr.
authors.forename: Dong-Jun
authors.initials: DJ
authors.lastname: Lim
authors.affiliation: Department of Bioengineering, University of Washington, Seattle, Washington, USA; Department of Creative IT Engineering, Pohang University of Science and Technology Pohang, Pohang, Korea.
authors.forename: Yongmin
authors.initials: Y
authors.lastname: Kim
mesh_terms: D000328:Adult; D000368:Aged; D000465:Algorithms; D044963:Biopsy, Fine-Needle / Q000706:statistics & numerical data*; D002114:Calcinosis / Q000000981:diagnostic imaging* / Q000473:pathology; D003937:Diagnosis, Differential; D054459:Elasticity Imaging Techniques; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D016606:Thyroid Nodule / Q000000981:diagnostic imaging* / Q000473:pathology
keywords: Calcification; Elastography; Fine-needle aspiration; Thyroid nodule