title: Elastography in the differential diagnosis of thyroid nodules.
abstract: Despite the publication of a recent meta-analysis of elastography in thyroid nodules, further work is necessary on this issue in different populations. In this study, we aimed to evaluate the clinical value of elastography on nodular goiters in mild iodine-deficient regions without excluding patients according to nodule characteristics. This prospective study was conducted between April 2010 and December 2011 in Yıldırım Beyazıt Dıskapı Research Hospital Endocrinology outpatient clinic. Five hundred twenty-eight nodular goiter patients who underwent thyroid fine-needle aspiration biopsy were included in our study. Elastography scores and indexes were measured with real-time ultrasound elastography (Hitachi® EUB 7000 HV machine with 13 MHz linear transducer). There were 471 females and 57 males and their ages ranged from 45 years to 78 years. A total of 601 nodules were evaluated in these patients. The area under the curve (AUC) for the elasto score was 0.91 (p < 0.0001) and AUC for the strain index (SI) was 0.96 (p < 0.0001). We suggest that the SI reflects malignancy better than the elasto score. We conclude that elastography scores greater than 3 have 76% sensitivity and 96% specificity for diagnosing malignancy. For SI, we conclude that 3.75 (83% sensitivity and 95% specificity) is the cutoff point. Elasto score and SI measurements of thyroid nodules in our population are efficient and increase the diagnostic performance of the sonography.
authors.affiliation: Endocrinology and Metabolism Department, Ankara Diskapi Training and Research Hospital, Turkey.
authors.forename: Erman
authors.initials: E
authors.lastname: Çakal
authors.affiliation: Endocrinology and Metabolism Department, Ankara University School of Medicine, Turkey drsahinmustafa@yahoo.com.
authors.forename: Mustafa
authors.initials: M
authors.lastname: Şahin
authors.affiliation: Endocrinology and Metabolism Department, Ankara Diskapi Training and Research Hospital, Turkey.
authors.forename: İlknur Öztürk
authors.initials: İÖ
authors.lastname: Ünsal
authors.affiliation: Endocrinology and Metabolism Department, Ankara Diskapi Training and Research Hospital, Turkey.
authors.forename: Aşkın
authors.initials: A
authors.lastname: Güngüneş
authors.affiliation: Endocrinology and Metabolism Department, Ankara Diskapi Training and Research Hospital, Turkey.
authors.forename: Esra
authors.initials: E
authors.lastname: Akkaymak
authors.affiliation: Endocrinology and Metabolism Department, Ankara Diskapi Training and Research Hospital, Turkey.
authors.forename: Evrim Çakır
authors.initials: EÇ
authors.lastname: Özkaya
authors.affiliation: Endocrinology and Metabolism Department, Ankara Diskapi Training and Research Hospital, Turkey.
authors.forename: Nujen Çolak
authors.initials: NÇ
authors.lastname: Bozkurt
authors.affiliation: Endocrinology and Metabolism Department, Ankara Diskapi Training and Research Hospital, Turkey.
authors.forename: Mustafa
authors.initials: M
authors.lastname: Özbek
authors.affiliation: Endocrinology and Metabolism Department, Ankara Diskapi Training and Research Hospital, Turkey.
authors.forename: Tuncay
authors.initials: T
authors.lastname: Delibaşı
mesh_terms: D000368:Aged; D019540:Area Under Curve; D003937:Diagnosis, Differential; D054459:Elasticity Imaging Techniques; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D016606:Thyroid Nodule / Q000000981:diagnostic imaging*
keywords: cancer; elastography; thyroid nodules