title: The role of elastosonography, gray-scale and colour flow Doppler sonography in prediction of malignancy in thyroid nodules.
abstract: BACKGROUND
  Ultrasound is as a noninvasive method commonly used in the work-up of thyroid nodules. This study aimed to evaluate the usefulness of sonographic and elastosonographic parameters in the discrimination of malignancy.
  
  
  METHODS
  150 thyroid nodules were evaluated by gray-scale, Doppler and elastosonography. The cytological analysis revealed that 141 nodules were benign and 9 were malignant.
  
  
  RESULTS
  Orientation of the nodule was the only sonographic parameter associated with malignancy (p = 0.003). In the strain ratio analysis the best cut-off point was 1.935 to discriminate malignancy (p = 0.000), with 100% sensitivity, 76% specificity, 100% negative predictive value, 78.5% positive predictive value and 78% accuracy rate. There was a statistically significant correlation between the elasticity score and malignancy (p = 0.001). Most of the benign nodules had score 2 and 3, none of them displayed score 5. On the other hand, none of the malignant nodules had score 1 and 2, most of them displaying score 5.
  
  
  CONCLUSIONS
  A change in the diagnostic algorithm of the thyroid nodules should be considered integrating the elastosonographic analysis.
authors.affiliation: Department of Radiology, Ankara Diskapı Training and Research Hospital, Ankara, Turkey.
authors.forename: Idil Gunes
authors.initials: IG
authors.lastname: Tatar
authors.affiliation: Department of Radiology, Ankara Diskapı Training and Research Hospital, Ankara, Turkey.
authors.forename: Aydin
authors.initials: A
authors.lastname: Kurt
authors.affiliation: Department of General Surgery, Ankara Diskapi Training and Research Hospital, Ankara, Turkey.
authors.forename: Kerim Bora
authors.initials: KB
authors.lastname: Yilmaz
authors.affiliation: Department of Pathology, Dr. Abdurrahman Yurtaslan Ankara Oncology Training and Research Hospital, Ankara, Turkey.
authors.forename: Mehmet
authors.initials: M
authors.lastname: Doğan
authors.affiliation: Department of Radiology, Ankara Diskapı Training and Research Hospital, Ankara, Turkey.
authors.forename: Baki
authors.initials: B
authors.lastname: Hekimoglu
authors.affiliation: Ankara Research and Training Hospital, Department of Pathology, Ankara, Turkey.
authors.forename: Sema
authors.initials: S
authors.lastname: Hucumenoglu
keywords: Doppler; elastosonography; thyroid, malignancy; ultrasound