title: Shear wave elastography of thyroid nodules for the prediction of malignancy in a large scale study.
abstract: OBJECTIVE
  The purpose of this study is to validate the usefulness of shear wave elastography (SWE) in predicting thyroid malignancy with a large-scale quantitative SWE data.
  
  
  METHODS
  This restrospective study included 476 thyroid nodules in 453 patients who underwent gray-scale US and SWE before US-guided fine-needle aspiration biopsy (US-FNA) or surgical excision were included. Gray-scale findings and SWE elasticity indices (EIs) were retrospectively reviewed and compared between benign and malignant thyroid nodules. The optimal cut-off values of EIs for predicting malignancy were determined. The diagnostic performances of gray-scale US and SWE for predicting malignancy were analyzed. The diagnostic performance was compared between the gray-scale US findings only and the combined use of gray-scale US findings with SWEs.
  
  
  RESULTS
  All EIs of malignant thyroid nodules were significantly higher than those of benign nodules (p≤.001). The optimal cut-off value of each EI for predicting malignancy was 85.2kPa of Emean, 94.0kPa of Emax, 54.0kPa of Emin. Emean (OR 3.071, p=.005) and Emax (OR 3.015, p=.003) were the independent predictors of thyroid malignancy. Combined use of gray-scale US findings and each EI showed elevated sensitivity (95.0-95.5% vs 92.9%, p≤.005) and AUC (0.820-0.834 vs 0.769, p≤.005) for predicting malignancy, compared with the use of only gray-scale US findings.
  
  
  CONCLUSIONS
  Quantitative parameters of SWE were the independent predictors of thyroid malignancy and SWE evaluation combined with gray-scale US was adjunctive to the diagnostic performance of gray-scale US for predicting thyroid malignancy.
authors.affiliation: Department of Radiology, Yonsei University College of Medicine, Gangnam Severance Hospital, Seoul, Republic of Korea.
authors.forename: Ah Young
authors.initials: AY
authors.lastname: Park
authors.affiliation: Department of Radiology, Yonsei University College of Medicine, Gangnam Severance Hospital, Seoul, Republic of Korea.
authors.forename: Eun Ju
authors.initials: EJ
authors.lastname: Son
authors.affiliation: Biostatistics Collaboration Unit, Gangnam Medical Research Center, Yonsei University College of Medicine, Gangnam Severance Hospital, Seoul, Republic of Korea.
authors.forename: Kyunghwa
authors.initials: K
authors.lastname: Han
authors.affiliation: Department of Radiology, Yonsei University College of Medicine, Gangnam Severance Hospital, Seoul, Republic of Korea.
authors.forename: Ji Hyun
authors.initials: JH
authors.lastname: Youk
authors.affiliation: Department of Radiology, Yonsei University College of Medicine, Gangnam Severance Hospital, Seoul, Republic of Korea. Electronic address: chrismd@hanmail.net.
authors.forename: Jeong-Ah
authors.initials: JA
authors.lastname: Kim
authors.affiliation: Department of Surgery, Yonsei University College of Medicine, Gangnam Severance Hospital, Seoul, Republic of Korea.
authors.forename: Cheong Soo
authors.initials: CS
authors.lastname: Park
mesh_terms: D000328:Adult; D000368:Aged; D044963:Biopsy, Fine-Needle; D054459:Elasticity Imaging Techniques; D005260:Female; D006801:Humans; D008297:Male; D008866:Microsurgery; D008875:Middle Aged; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D013964:Thyroid Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology; D016606:Thyroid Nodule / Q000000981:diagnostic imaging* / Q000473:pathology
keywords: Malignancy; Shear wave elastography; Thyroid nodule