title: Elastosonography scoring and strain index of thyroid nodules with Hurthle cells.
abstract: BACKGROUND
  This study evaluated the effectiveness of elastosonography (ES) scoring and strain index (SI) in diagnosing patients with thyroid nodules composed primarily of Hurthle cells.
  
  
  METHODS
  This study retrospectively analyzed 57 patients with thyroid nodules composed predominantly of Hurthle cells on fine needle aspiration cytology (FNAC). Patients were evaluated by thyroid ultrasonography (US), ES scoring, SI, US guided FNAC, and histopathology.
  
  
  RESULTS
  Histopathologically, 12 (21.1%) nodules were malignant and 45 (78.9%) were benign. Mean age, sex distribution, thyroid function tests, and morphologic features on US were similar in the malignant and benign groups. Mean SI (40.98±31.28 vs 21.24±25.47, p=0.027) and thyroid peroxidase antibody (anti-TPOab) positivity (p=0.004) were significantly higher in malignant than in benign nodules. Receiver operating curve (ROC) analysis showed that an SI cutoff of 10.326 had a sensitivity of 91.7% and a specificity of 49%, and an SI cut-off of 64.807 had a specificity of 91.1% and a sensitivity of 25%. The optimal SI cut-off value, 17.877, had a sensitivity of 66.7%, a specificity of 66.7%, a positive predictive value (PPV) of 34.8%, a negative predictive value (NPV) of 88.2%, and an area under the ROC curve of 73.1±0.074% (95% CI: 58.7-87.6.5%). The sensitivity, specificity, PPV, NPV and diagnostic accuracy of ES scoring were 41.6%, 91.1%, 55.5%, 85.4% and 80.7%, respectively.
  
  
  CONCLUSIONS
  This is the first study to investigate ES scoring and SI in nodules composed predominantly of Hurthle cells on FNAC. ES scoring and SI may add some contribution to ultrasonography in the characterization of thyroid nodules with Hurthle cells.
authors.affiliation: Department of Endocrinology and Metabolism, Ankara Atatürk Research and Training Hospital, Ankara, Turkey - tuzund@gmail.com.
authors.forename: Dilek
authors.initials: D
authors.lastname: Tuzun
authors.forename: Reyhan
authors.initials: R
authors.lastname: Ersoy
authors.forename: Aylin
authors.initials: A
authors.lastname: Kilicyazgan
authors.forename: GUlten
authors.initials: G
authors.lastname: Kiyak
authors.forename: Samet
authors.initials: S
authors.lastname: Yalcin
authors.forename: Bekir
authors.initials: B
authors.lastname: Cakir
mesh_terms: D000328:Adult; D000368:Aged; D044963:Biopsy, Fine-Needle; D054459:Elasticity Imaging Techniques; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D024862:Oxyphil Cells / Q000473:pathology*; D012189:Retrospective Studies; D016606:Thyroid Nodule / Q000000981:diagnostic imaging* / Q000473:pathology; D014463:Ultrasonography; D055815:Young Adult