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- Title
Q-Elastosonography of Solid Thyroid Nodules: Assessment of Diagnostic Efficacy and Interobserver Variability in a Large Patient Cohort.
- Authors
Cantisani, Vito; Grazhdani, Hektor; Ricci, Paolo; Mortele, Koenraad; Di Segni, Mattia; D'Andrea, Vito; Redler, Adriano; Di Rocco, Giorgio; Giacomelli, Laura; Maggini, Elena; Chiesa, Carlo; Erturk, Sukru; Sorrenti, Salvatore; Catalano, Carlo; D'Ambrosio, Ferdinando
- Abstract
Objective: Evaluation of the diagnostic efficacy and interobserver agreement of Q-elastography in the differentiation of benign from malignant thyroid nodules. Methods: A total of 344 thyroid nodules in 288 patients were examined with grey-scale and colour Doppler ultrasound (CDUS) and Q-elastography by two independent operators. Nodules with hypoechogenicity, poorly defined margins, microcalcifications, and intralesional vascularity were classified as suspicious. Diagnostic performances of CDUS features and Q-elastography for predicting thyroid malignancy were estimated using ROC analysis. Cytology or histopathology was the reference standard. Interobserver agreement in the evaluation of CDUS and Q-elastography was assessed using Cohen's k-statistic. Results: Q-elastography showed excellent diagnostic performance for the prediction of thyroid malignancy, with sensitivity of 93 % and specificity of 92 % for operator 1 (best cutoff at 2.02), and sensitivity of 84 % and specificity of 79 % for operator 2 (best cutoff at 1.86). Performance of Q-elastography was superior to that of CDUS. Reproducibility of the findings was excellent for both Q-elastography and CDUS features as assessed with Cohen's k, which was highest for strain ratio measurements (0.95) and lowest for the echogenicity score (0.83). Conclusions: Q-elastography showed excellent performance. It is a valid and reproducible diagnostic method as well as a promising tool for identifying suspicious solid thyroid nodules needing cytological assessment and surgery. Key Points: • Elastography is an additional tool for optimal characterisation of malignant thyroid nodules. • The use of semiquantitative elastographic evaluation increases the diagnostic performance, • The interobserver agreement of quantitative elastography can be considered to be good.
- Subjects
THYROID gland tumors; DOPPLER ultrasonography; CYTOLOGICAL research; SURGERY; HISTOLOGY
- Publication
European Radiology, 2014, Vol 24, Issue 1, p143
- ISSN
0938-7994
- Publication type
Article
- DOI
10.1007/s00330-013-2991-y