title: Elastography in Distinguishing Benign from Malignant Thyroid Nodules.
abstract: OBJECTIVE
  The aim of this study is to test the diagnostic success of strain elastography in distinguishing benign from malignant thyroid nodules.
  
  
  METHODS
  The size, echogenicity, and halo integrity of 293 thyroid nodules and the presence of microcalcification in these nodules were evaluated on gray-scale examination. Doppler characteristics and elastography patterns were also evaluated and recorded. Nodules were classified in four categories (patterns 1-4) based on elastographic examination.
  
  
  RESULTS
  According to the cytopathological findings, 222 nodules were benign, and 71 nodules were malignant. The risk of a nodule to be malignant was 3.8 times increased by hypoechogenicity, 7.7 times increased by the presence of microcalcification, and 11.5 times increased by the absence of halo. On Doppler patterns, the presence of central vascularity increased the malignancy risk of a nodule by 5.8 times. According to the receiver operating characteristic analysis, patterns 3 and 4 were malignant, and patterns 1 and 2 were benign. The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of elastography were 100%, 80.2%, 61.7%, 100%, and 85%, respectively.
  
  
  CONCLUSIONS
  Strain elastography can be used as a noninvasive method in distinguishing benign from malignant thyroid nodules and in identifying the patients who would undergo surgery.
authors.affiliation: Department of Radiology, Vehbi Koç Foundation American Hospital, Istanbul, Turkey.
authors.forename: Bulent
authors.initials: B
authors.lastname: Colakoglu
authors.affiliation: Department of Radiology, Acıbadem Taksim Hospital, Istanbul, Turkey.
authors.forename: Duzgun
authors.initials: D
authors.lastname: Yildirim
authors.affiliation: Department of Radiology, Cerrahpasa Medical Faculty, Istanbul University, Istanbul, Turkey.
authors.forename: Deniz
authors.initials: D
authors.lastname: Alis
authors.affiliation: Department of Radiology, Vehbi Koç Foundation American Hospital, Istanbul, Turkey.
authors.forename: Gokhan
authors.initials: G
authors.lastname: Ucar
authors.affiliation: Department of Radiology, Cerrahpasa Medical Faculty, Istanbul University, Istanbul, Turkey.
authors.forename: Cesur
authors.initials: C
authors.lastname: Samanci
authors.affiliation: Department of Radiology, Cerrahpasa Medical Faculty, Istanbul University, Istanbul, Turkey.
authors.forename: Fethi Emre
authors.initials: FE
authors.lastname: Ustabasioglu
authors.affiliation: Department of Biostatistics, Cerrahpasa Medical Faculty, Istanbul University, Istanbul, Turkey.
authors.forename: Alev
authors.initials: A
authors.lastname: Bakir
authors.affiliation: Department of Radiology, Florence Nightingale Hospital, Istanbul, Turkey.
authors.forename: Onur Levent
authors.initials: OL
authors.lastname: Ulusoy
keywords: Benign; elastography; malignant; thyroid nodule