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Article type: Research Article
Authors: He, Ya-Pinga; b; c | Xu, Hui-Xionga; b; c; * | Wang, Dana; b; c | Li, Xiao-Longa; b; c | Ren, Wei-Weia; b; c | Zhao, Chong-Kea; b; c | Bo, Xiao-Wana; b; c | Liu, Bo-Jia; b; c | Yue, Wen-Wena; b; c
Affiliations: [a] Department of Medical Ultrasound, Shanghai Tenth People’s Hospital, Ultrasound Research and Education Institute, Tongji University School of Medicine, Shanghai, China | [b] Thyroid Institute, Tongji University School of Medicine, Shanghai, China | [c] Shanghai Research Center for Thyroid Diseases, Shanghai, China
Correspondence: [*] Corresponding author: Hui-Xiong Xu, MD, PhD, Department of Medical Ultrasound, Shanghai Tenth People’s Hospital, Ultrasound Research and Education Institute, Tongji University School of Medicine, No. 301, Yangchangzhong Road, Shanghai 200072, China. Tel.: +86 21 66307539; E-mail: [email protected].
Abstract: OBJECTIVE: The purpose of this study was to comparatively evaluate the two different shear wave speed (SWS) imaging systems of Toshiba shear wave elastography (T-SWE) and SuperSonic SWE (S-SWE) in distinguishing malignant from benign thyroid nodules (TNs). MATERIALS AND METHODS: 140 patients with 140 focal TNs were enrolled and underwent T-SWE and S-SWE before fine-needle aspiration (FNA) biopsy or surgery. SWE indices of mean, standard deviation and maximum values (E-mean, E-SD and E-max) of elastic modulus in TNs were measured on a color-coded mapping. The receiver operating characteristic (ROC) curve was performed to assess the diagnostic performance. RESULTS: Of the 140 nodules, 47 were thyroid carcinomas and 93 were benign. Areas under the receiver operating characteristic curve (AUC) were the highest with E-max among the three SWE parameters both for T-SWE and S-SWE (0.816 and 0.799). The most accurate cut-off values, sensitivity, specificity, accuracy, positive predictive value (PPV) and negative predictive value (NPV) were 26.6 kPa versus 42.9 kPa, 83.0% versus 63.8%, 68.8% versus 88.2%, 72.9% versus 80.0%, 56.5% versus 73.2% and 88.7% versus 82.8% with E-max for T-SWE and S-SWE, respectively. Among these comparisons, the sensitivity in T-SWE was statistically higher than S-SWE (83.0% versus 63.8%, p = 0.022), whereas specificity was statistically lower than S-SWE (68.8% versus 88.2%, p < 0.001). CONCLUSION: T-SWE is equal to S-SWE with comparable and promising results for diagnosis of TNs. In clinical using, the selection of E-max should be recommended both for T-SWE and S-SWE.
Keywords: Acoustic radiation force impulse, shear wave elastography, ultrasound, thyroid nodules, fine-needle aspiration, diagnostic performance
DOI: 10.3233/CH-16197
Journal: Clinical Hemorheology and Microcirculation, vol. 65, no. 4, pp. 349-361, 2017
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