The Role of Elastosonography, Gray-Scale and Color Flow Doppler Sonography In Prediction of Malignancy in Thyroid Nodules

Abstract

Introduction. Ultrasound is as a noninvasive method commonly used in the work-up of thyroid nodules. This study aimed to evaluate the usefulness of sonographic and elastosonographic parameters in the discrimination of malignancy.

Materials and Methods. 150 thyroid nodules were evaluated by gray-scale, Doppler and elastosonography. Histopathologic analysis revealed that 141 nodules were benign and 9 were malignant.

Results. Orientation of the nodule was the only sonographic parameter associated with malignancy (p=0.003). In the strain ratio analysis the best cut-off point was 1.935 to discriminate malignancy (p=0,000), with 100% sensitivity, 76% specificity, 100% negative predictive value, 78.5% positive predictive value and 78% accuracy rate. There was a statistically significant correlation between the elasticity score and malignancy (p= 0.001). Most of the benign nodules had score 2 and 3, none of them displayed score 5. On the other hand, none of the malignant nodules had score 1 and 2, most of them displaying score 5.

Conclusions. A change in the diagnostic algorithm of the thyroid nodules should be considered integrating the elastosonographic analysis.