title: Diagnostic value of two-dimensional shear wave elastography in papillary thyroid microcarcinoma.
abstract: OBJECTIVE
  The purpose of this study was to evaluate the predictability of two-dimensional shear wave elastography (2D-SWE) for papillary thyroid microcarcinoma (PTMC).
  
  
  METHODS
  One hundred and eighteen patients with 137 thyroid nodules (46 benign nodules, 91 malignant nodules) were included in this study who received conventional ultrasound (US) and 2D-SWE before fine-needle aspiration or surgery. The diagnostic performance was compared between US findings only and the combined use of US findings with 2D-SWE, which were correlated with pathology results.
  
  
  RESULTS
  Receiver-operating characteristic curve analysis was performed to assess the diagnostic performance of 2D-SWE. Conventional US findings and 2D-SWE values were analyzed and compared between benign and malignant thyroid nodules. The mean values of SWE_mean, SWE_min, and SWE_max were 46.6±16.7, 26.2±9.5, and 73.6±18.1 kPa, respectively, in PTMC, which were significantly higher than those in benign tumors (27.8±12.4, 15.8±8.6, and 50.3±22.6 kPa, P<0.001). The optimal cut-off values of SWE_mean, SWE_min, and SWE_max for predicting malignancy were 34.5, 21.8, and 53.2 kPa, respectively. Taller than wide, micro-calcification, and SWE_mean were found to be independent risk factors for predicting PTMC. The overall sensitivity, specificity, accuracy, positive predictive value, and negative predictive value of combined conventional US features with 2D-SWE parameters were 95.7%, 94.5%, 94.9%, 89.8%, and 97.7%, respectively; these were superior to those of conventional US (89.1%, 90.1%, 89.9%, 82.0%, and 93.2%).
  
  
  CONCLUSIONS
  The study indicates that the quantitative parameters of 2D-SWE are an independent predictive factor for diagnosing PTMC, which could provide valuable information when conventional US cannot give determinate results.
authors.affiliation: Department of Interventional Ultrasound, Medical Center Tsinghua University, Beijing, People's Republic of China; Department of Interventional Ultrasound, PLA General Hospital, Beijing, People's Republic of China.
authors.forename: Shao-Bo
authors.initials: SB
authors.lastname: Duan
authors.affiliation: Department of Interventional Ultrasound, PLA General Hospital, Beijing, People's Republic of China.
authors.forename: Jie
authors.initials: J
authors.lastname: Yu
authors.affiliation: Department of Interventional Ultrasound, PLA General Hospital, Beijing, People's Republic of China.
authors.forename: Xin
authors.initials: X
authors.lastname: Li
authors.affiliation: Department of Interventional Ultrasound, PLA General Hospital, Beijing, People's Republic of China.
authors.forename: Zhi-Yu
authors.initials: ZY
authors.lastname: Han
authors.affiliation: Department of Interventional Ultrasound, PLA General Hospital, Beijing, People's Republic of China.
authors.forename: Hong-Yan
authors.initials: HY
authors.lastname: Zhai
authors.affiliation: Department of Interventional Ultrasound, PLA General Hospital, Beijing, People's Republic of China.
authors.forename: Ping
authors.initials: P
authors.lastname: Liang
keywords: diagnostic performance; malignancy; shear wave elastography; thyroid nodule