Abstract
Italy Context: Ultrasound (US) elastography (USE) was recently been reported as a sensitive, noninvasive tool for identifying thyroid cancer. However, the accuracy of this technique is hampered by the intra- and interoperator variability, some US features of the nodule, and the coexistence of autoimmune thyroid disease (ATD). Objectives: The purpose of this article was to assess the accuracy of USE findings in the differential diagnosis of thyroid nodules compared with other US features to evaluate its feasibility in the presence of ATDs and identify the strain index (SI) cutoff with the highest diagnostic performance. Design: We evaluated 528 consecutive patients for a total of 661 thyroid nodules. All nodules underwent fine-needle aspiration cytology (FNAC) and USE evaluation. The SI was calculated as a ratio of the nodule strain divided by the strain of the softest part of the surrounding normal tissue. Results: The median SI value was significantly higher in THY4 and THY5 than in THY2 nodules in ATD-positive, ATD-negative, and ATD-unknown patients. The cutoff of SI for malignancy was estimated to be 2.905 by receiver operating characteristic curve analysis in a screening set (379 FNACresults), and then tested in a replication set (252FNACresults). In all cases, a SI value of≥2.905 conferred to the nodule a significantly greater probability of being malignant. This SI cutoff had the greatest area under the curve, sensitivity, and negative predictive value, compared with the conventional US features of malignancy. Conclusion: The elastographic SI has a high sensitivity, specificity, and negative predictive value for the diagnosis of thyroid malignancy both in the presence and in the absence of ATD. If our data on USE are also confirmed in THY3 nodules, FNAC could be avoided in a number of thyroid nodules with certain features.
| Original language | English |
|---|---|
| Pages (from-to) | 4790-4797 |
| Number of pages | 8 |
| Journal | Journal of Clinical Endocrinology and Metabolism |
| Volume | 98 |
| Issue number | 12 |
| DOIs | |
| Publication status | Published - Dec 2013 |
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ASJC Scopus subject areas
- Biochemistry
- Clinical Biochemistry
- Endocrinology
- Biochemistry, medical
- Endocrinology, Diabetes and Metabolism
- Medicine(all)
Cite this
Comparison of elastographic dtrain index and thyroid fine-Needle aspiration cytology in 631 thyroid nodules. / Magri, Flavia; Chytiris, Spyridon; Capelli, Valentina; Gaiti, Margherita; Zerbini, Francesca; Carrara, Roberto; Malovini, Alberto; Rotondi, Mario; Bellazzi, Riccardo; Chiovato, Luca.
In: Journal of Clinical Endocrinology and Metabolism, Vol. 98, No. 12, 12.2013, p. 4790-4797.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Comparison of elastographic dtrain index and thyroid fine-Needle aspiration cytology in 631 thyroid nodules
AU - Magri, Flavia
AU - Chytiris, Spyridon
AU - Capelli, Valentina
AU - Gaiti, Margherita
AU - Zerbini, Francesca
AU - Carrara, Roberto
AU - Malovini, Alberto
AU - Rotondi, Mario
AU - Bellazzi, Riccardo
AU - Chiovato, Luca
PY - 2013/12
Y1 - 2013/12
N2 - Italy Context: Ultrasound (US) elastography (USE) was recently been reported as a sensitive, noninvasive tool for identifying thyroid cancer. However, the accuracy of this technique is hampered by the intra- and interoperator variability, some US features of the nodule, and the coexistence of autoimmune thyroid disease (ATD). Objectives: The purpose of this article was to assess the accuracy of USE findings in the differential diagnosis of thyroid nodules compared with other US features to evaluate its feasibility in the presence of ATDs and identify the strain index (SI) cutoff with the highest diagnostic performance. Design: We evaluated 528 consecutive patients for a total of 661 thyroid nodules. All nodules underwent fine-needle aspiration cytology (FNAC) and USE evaluation. The SI was calculated as a ratio of the nodule strain divided by the strain of the softest part of the surrounding normal tissue. Results: The median SI value was significantly higher in THY4 and THY5 than in THY2 nodules in ATD-positive, ATD-negative, and ATD-unknown patients. The cutoff of SI for malignancy was estimated to be 2.905 by receiver operating characteristic curve analysis in a screening set (379 FNACresults), and then tested in a replication set (252FNACresults). In all cases, a SI value of≥2.905 conferred to the nodule a significantly greater probability of being malignant. This SI cutoff had the greatest area under the curve, sensitivity, and negative predictive value, compared with the conventional US features of malignancy. Conclusion: The elastographic SI has a high sensitivity, specificity, and negative predictive value for the diagnosis of thyroid malignancy both in the presence and in the absence of ATD. If our data on USE are also confirmed in THY3 nodules, FNAC could be avoided in a number of thyroid nodules with certain features.
AB - Italy Context: Ultrasound (US) elastography (USE) was recently been reported as a sensitive, noninvasive tool for identifying thyroid cancer. However, the accuracy of this technique is hampered by the intra- and interoperator variability, some US features of the nodule, and the coexistence of autoimmune thyroid disease (ATD). Objectives: The purpose of this article was to assess the accuracy of USE findings in the differential diagnosis of thyroid nodules compared with other US features to evaluate its feasibility in the presence of ATDs and identify the strain index (SI) cutoff with the highest diagnostic performance. Design: We evaluated 528 consecutive patients for a total of 661 thyroid nodules. All nodules underwent fine-needle aspiration cytology (FNAC) and USE evaluation. The SI was calculated as a ratio of the nodule strain divided by the strain of the softest part of the surrounding normal tissue. Results: The median SI value was significantly higher in THY4 and THY5 than in THY2 nodules in ATD-positive, ATD-negative, and ATD-unknown patients. The cutoff of SI for malignancy was estimated to be 2.905 by receiver operating characteristic curve analysis in a screening set (379 FNACresults), and then tested in a replication set (252FNACresults). In all cases, a SI value of≥2.905 conferred to the nodule a significantly greater probability of being malignant. This SI cutoff had the greatest area under the curve, sensitivity, and negative predictive value, compared with the conventional US features of malignancy. Conclusion: The elastographic SI has a high sensitivity, specificity, and negative predictive value for the diagnosis of thyroid malignancy both in the presence and in the absence of ATD. If our data on USE are also confirmed in THY3 nodules, FNAC could be avoided in a number of thyroid nodules with certain features.
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U2 - 10.1210/jc.2013-2672
DO - 10.1210/jc.2013-2672
M3 - Article
C2 - 24064692
AN - SCOPUS:84889805801
VL - 98
SP - 4790
EP - 4797
JO - Journal of Clinical Endocrinology and Metabolism
JF - Journal of Clinical Endocrinology and Metabolism
SN - 0021-972X
IS - 12
ER -