Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2020 Dec;9(6):2136-2143.
doi: 10.21037/gs-20-819.

Application of ultrasonic shear wave elastography and contrast-enhanced ultrasound in the differential diagnosis of patients with benign and malignant thyroid lesions

Jing Xu  1 , Ping Wang  2 , Wensheng Yue  2 , Yuqun Luo  2 , Zukun Li  2
Affiliations

Application of ultrasonic shear wave elastography and contrast-enhanced ultrasound in the differential diagnosis of patients with benign and malignant thyroid lesions

Jing Xu et al. Gland Surg. 2020 Dec.

Abstract

Background: Thyroid nodules are a common thyroid disorder. The aim of the present study was to observe the application value of ultrasonic shear wave elastography (SWE) and contrast-enhanced ultrasound (CEUS) in the differential diagnosis of patients with benign and malignant thyroid lesions.

Methods: Eighty-two patients with thyroid nodules (96 thyroid nodules) at our hospital were enrolled. All patients underwent ultrasonic SWE and CEUS examination. With surgical pathology as the gold standard, the Young's modulus, CEUS imaging features, and quantitative parameters were compared between the benign and malignant groups. The diagnostic efficiency of SWE, CEUS, and their combination was analyzed by receiver-operating characteristic curve (ROC).

Results: The average of the Young's modulus in the malignant group was significantly higher than that of the benign group (P<0.05). There were significant differences in the CEUS images of nodules between the benign and malignant groups in terms of boundary conditions, morphology, perfusion intensity, homogeneous enhancement, and perfusion defects (P<0.05), while there were no significant difference in initial increase time, peak intensity, time to peak, and area under the curve (P>0.05). The curve sharpness in the benign group was significantly lower than that of the malignant group (P<0.05). ROC analysis found that the diagnostic sensitivity and specificity of SWE, CEUS, and their combination were 90.1% and 81.6%, 67.8% and 75.4%, and 97.3% and 71.5%, respectively.

Conclusions: Compared with CEUS, the sensitivity and specificity of SWE were relatively higher in the differential diagnosis of benign and malignant thyroid lesions, and a combination of both can improve the diagnostic sensitivity of SWE alone to a certain extent.

Keywords: Ultrasonic shear wave elastography (ultrasonic SWE); contrast-enhanced ultrasound (CEUS); differential diagnosis; thyroid lesion.

PubMed Disclaimer

Conflict of interest statement

Conflicts of Interest: All authors have completed the ICMJE uniform disclosure form (available at http://dx.doi.org/10.21037/gs-20-819). The authors have no conflicts of interest to declare.

Figures

Figure 1
Figure 1
Shear wave elastography (SWE) sonogram of benign nodules. Nodular goiter detected by SWE. (A) Nodules showing homogenous enhancement are shown in blue. Maximum hardness position (arrow) has an average Young’s modulus value of 22.38 kPa. (B) 2D grayscale ultrasound image.
Figure 2
Figure 2
Shear wave elastography (SWE) sonogram of malignant nodules. Papillary thyroid carcinoma detected by SWE. (A) Rich nodules are in red. Maximum hardness position (arrow) had an average Young’s modulus value of 106.54 kPa. (B) 2D grayscale ultrasound image.
Figure 3
Figure 3
Contrast-enhanced ultrasound image of malignant. Thyroid papillary carcinoma showing low enhancement.
Figure 4
Figure 4
Contrast-enhanced ultrasound image of benign nodules. Nodular goiter showing homogeneous enhancement.
Figure 5
Figure 5
Receiver-operating characteristic curve analysis of benign and malignant thyroid lesions diagnosed by contrast-enhanced ultrasound (CEUS) and shear wave elastography (SWE).
See this image and copyright information in PMC

References

    1. Hoang JK, Middleton WD, Farjat AE, et al. Reduction in Thyroid Nodule Biopsies and Improved Accuracy with American College of Radiology Thyroid Imaging Reporting and Data System. Radiology 2018;287:185-93. 10.1148/radiol.2018172572 - DOI - PubMed
    1. Kitahara CM, Preston DL, Neta G, et al. Occupational radiation exposure and thyroid cancer incidence in a cohort of U.S. radiologic technologists, 1983-2013. Int J Cancer 2018;143:2145-9. 10.1002/ijc.31270 - DOI - PMC - PubMed
    1. Suh CH, Baek JH, Lee JH, et al. The role of core-needle biopsy in the diagnosis of thyroid malignancy in 4580 patients with 4746 thyroid nodules: a systematic review and meta-analysis. Endocrine 2016;54:315-28. 10.1007/s12020-016-0991-9 - DOI - PubMed
    1. Cui K, Zhang M, Fu C, et al. Comment on “Partially Cystic Thyroid Nodules on Ultrasound: Probability of Malignancy and Sonographic Differentiation”. Thyroid 2016;26:1645. 10.1089/thy.2016.0389 - DOI - PubMed
    1. Bhatia P, Deniwar A, Friedlander P, et al. Diagnostic potential of ancillary molecular testing in differentiation of benign and malignant thyroid nodules. Anticancer Res 2015;35:1237-41. - PubMed