Comparison of elastographic dtrain index and thyroid fine-Needle aspiration cytology in 631 thyroid nodules

Flavia Magri, Spyridon Chytiris, Valentina Capelli, Margherita Gaiti, Francesca Zerbini, Roberto Carrara, Alberto Malovini, Mario Rotondi, Riccardo Bellazzi, Luca Chiovato

Research output: Contribution to journalArticle

24 Citations (Scopus)

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 languageEnglish
Pages (from-to)4790-4797
Number of pages8
JournalJournal of Clinical Endocrinology and Metabolism
Volume98
Issue number12
DOIs
Publication statusPublished - Dec 2013

Fingerprint

Cytology
Thyroid Nodule
Thyroid Diseases
Elasticity Imaging Techniques
Fine Needle Biopsy
Needles
Autoimmune Diseases
Cell Biology
Thyroid Gland
Ultrasonics
Neoplasms
Thyroid Neoplasms
ROC Curve
Italy
Area Under Curve
Differential Diagnosis
Sensitivity and Specificity
Screening
Tissue

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 journalArticle

@article{f56fda605efb4eed924671bc88f2d384,
title = "Comparison of elastographic dtrain index and thyroid fine-Needle aspiration cytology in 631 thyroid nodules",
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.",
author = "Flavia Magri and Spyridon Chytiris and Valentina Capelli and Margherita Gaiti and Francesca Zerbini and Roberto Carrara and Alberto Malovini and Mario Rotondi and Riccardo Bellazzi and Luca Chiovato",
year = "2013",
month = "12",
doi = "10.1210/jc.2013-2672",
language = "English",
volume = "98",
pages = "4790--4797",
journal = "Journal of Clinical Endocrinology and Metabolism",
issn = "0021-972X",
publisher = "The Endocrine Society",
number = "12",

}

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.

UR - http://www.scopus.com/inward/record.url?scp=84889805801&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84889805801&partnerID=8YFLogxK

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 -