Download PDF
CC BY-NC-ND 4.0 · Indian J Radiol Imaging 2013; 23(04): 337-341
DOI: 10.4103/0971-3026.125612
Head and Neck Radiology

Qualitative ultrasound elastography assessment of benign thyroid nodules: Patterns and intra-observer acquisition variability

Alexis Lacout
Centre d′imagerie Médicale, 47 Boulevard du Pont Rouge, 15000 Aurillac, France.
,
Carole Chevenet
Centre de Pathologie, 23 av République, 15000 Aurillac, France.
,
Juliette Thariat
Department of Radiation Oncology, Antoine Lacassagne Cancer Research Center, 33 Avenue Valombrose, 06189 NICE cedex 1, France.
,
Andrea Figl
Department Oncology Breast Surgery, Antoine Lacassagne Cancer Research Center, 33 Avenue Valombrose, 06189 NICE cedex 1, France.
,
Pierre-Yves Marcy
Department of Medical Imaging, François Baclesse Center, 3, Avenue du Général Harris, 14076 Caen cedex 05, France.
› Author Affiliations Financial support and sponsorship Nil.
› Further Information
  PDF Download Permissions and Reprints

Abstract

Purpose: To report and evaluate qualitative elastography patterns by using gray-scale and Doppler ultrasound (US) in patients presenting with benign thyroid nodules and to evaluate the reproducibility of US elastography examinations. Materials and Methods: Institutional review board approval was obtained, and all patients provided informed consent. Over a 3-month time period, all consecutive adult patients were referred to our institution to undergo a thyroid nodule fine-needle aspiration biopsy (FNAB) procedure. Patients presenting with benign cytology according to the Bethesda 2008 classification were prospectively enrolled in the study. Each thyroid nodule was assessed by using gray-scale, Doppler US, and elastography acquisitions by a single operator (A. L.). Multiple elastography acquisitions per thyroid nodule were performed and elastography scorings of the nodules were compared with each other. Results: Nineteen patients (16 women and 3 men, mean age 58 years) with 22 thyroid nodules were included in the present study. Elastographic patterns 1, 2, and 3 were reported (23% nodules showed pattern 3). The elastography pattern showed a strong variability in 13 nodules (59%). The elastography acquisition result variability involved the "malignant" pattern 3 in 36% of cases. Conclusion: Almost one-third of benign thyroid nodules displayed pattern 3 on qualitative US elastography. The intra-observer variability of the benign thyroid elastography scoring is wide, thus limiting the thyroid nodule US examination accuracy. In FNAB-proven benign thyroid nodules, elastography pattern 3 is frequent and cannot be used as a strong indicator of thyroid malignancy.

Keywords

Elastography - pattern - thyroid - variability


Publication History

Article published online:
30 July 2021

© 2013. Indian Radiological Association. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).

Thieme Medical and Scientific Publishers Private Ltd.
A-12, Second Floor, Sector -2, NOIDA -201301, India

 

  • References

  • 1 Guth S, Theune U, Aberle J, Galach A, Bamberger CM. Very high prevalence of thyroid nodules detected by high frequency (13 MHz) ultrasound examination. Eur J Clin Invest 2009;39:699-706.
  • 2 Baier ND, Hahn PF, Gervais DA, Samir A, Halpern EF, Mueller PR, et al. Fine-needle aspiration biopsy of thyroid nodules: Experience in a cohort of 944 patients. Am J Roentgenol 2009;193:1175-9.
  • 3 Gharib H, Goellner JR. Fine-needle aspiration biopsy of the thyroid: An appraisal. Ann Intern Med 1993;118:282-9.
  • 4 Kim EK, Park CS, Chung WY, Oh KK, Kim DI, Lee JT, et al. New sonographic criteria for recommending fine-needle aspiration biopsy of nonpalpable solid nodules of the thyroid. AJR Am J Roentgenol 2002;178:687-91.
  • 5 Ophir J, Céspedes I, Ponnekanti H, Yazdi Y, Li X. Elastography: A quantitative method for imaging the elasticity of biological tissues. Ultrason Imaging 1991;13:111-34.
  • 6 Kagoya R, Monobe H, Tojima H. Utility of elastography for differential diagnosis of benign and malignant thyroid nodules. Otolaryngol Head Neck Surg 2010;143:230-4.
  • 7 Horvath E, Majlis S, Rossi R, Franco C, Niedmann JP, Castro A, et al. An ultrasonogram reporting system for thyroid nodules stratifying cancer risk for clinical management. J Clin Endocrinol Metab 2009;94:1748-51.
  • 8 Ning CP, Jiang SQ, Zhang T, Sun LT, Liu YJ, Tian JW. The value of strain ratio in differential diagnosis of thyroid solid nodules. Eur J Radiol 2012;81:286-91.
  • 9 Yoon JH, Kim MH, Kim EK, Moon HJ, Kwak JY, Kim MJ. Interobserver variability of ultrasound elastography: How it affects the diagnosis of breast lesions. AJR Am J Roentgenol 2011;196:730-6
  • 10 Park SH, Kim SJ, Kim EK, Kim MJ, Son EJ, Kwak JY. Interobserver agreement in assessing the sonographic and elastographic features of malignant thyroid nodules. AJR Am J Roentgenol 2009;193:W416-23.
  • 11 Luo S, Lim DJ, Kim Y. Objective ultrasound elastography scoring of thyroid nodules using spatiotemporal strain information. Med Phys 2012;39:1182-9.
  • 12 Sebag F, Vaillant-Lombard J, Berbis J, Griset V, Henry JF, Petit P, et al. Shear wave elastography: A new ultrasound imaging mode for the differential diagnosis of benign and malignant thyroid nodules. J Clin Endocrinol Metab 2010;95:5281-8.
  • 13 Bercoff J, Tanter M, Fink M. Supersonic shear imaging: A new technique for soft tissue elasticity mapping. IEEE Trans Ultrason Ferroelectr Freq Control 2004;51:396-409.
  • 14 Marcy PY, Thariat J, Lacout A. Should we catch the train of shear-wave elastography? AJR Am J Roentgenol 2012;198:W624-5..