Ultraschall Med 2016; 37 - SL7_1
DOI: 10.1055/s-0036-1587743

Results of the DEGUM-multicenter study evaluating strain elastography for differentiation of thyroid nodules

M Friedrich-Rust 1, C Vorländer 2, CF Dietrich 3, W Kratzer 4, W Blank 5, A Schuler 6, N Broja 1, XW Cui 3, E Herrmann 7, J Bojunga 1
  • 1Klinikum der J.W. Goethe Universität, Medizinische Klinik 1, Frankfurt am Main, Germany
  • 2Abteilung für endokrine Chirurgie, Bürgerhospital Frankfurt, Frankfurt, Germany
  • 3Caritas Krankenhaus Bad Mergentheim, Bad Mergentheim, Germany
  • 4Universitätsklinikum Ulm, Ulm, Germany
  • 5Krankenhaus am Steinberg, Reutlingen, Germany
  • 6Helfenstein Krankenhaus, Geislingen, Germany
  • 7Institut für Biostatistik und Medizinische Modellierung, Universität Frankfurt, Frankfurt, Germany

Purpose: Many patients with thyroid nodules are presently referred to surgery not only for therapeutic but also for diagnostic purposes. Strain elastography (SE) enables the ultrasound-based determination of tissue elasticity. The aim of the present study was to evaluate the value of SE for differentiation of thyroid nodules in a prospective multicenter study.

Material and methods: The study was registered at clinicaltrials.gov and was approved by the local ethical committees of all participating centers. All patients received an ultrasound (US) of the thyroid gland including Colour Doppler US. In addition all nodules were evaluated by SE (Hitachi Medical Systems) using qualitative image interpretation of colour distribution (SE-ES), strain value and strain ratio.

Results: Overall, 602 patients with 657 thyroid nodules (567 benign, 90 malignant) from 7 centers were included in the final analysis. Sensitivity, specificity, NPV, PPV, +LR were 21%, 73%, 86%, 11%, 0.8 for colour Doppler US; 69%, 75%, 94%, 30%, 2.9 for SE-ES; 56%, 81%, 92%, 32%, 2.9 for SE-strain value; 58%, 78%, 92%, 30%, 2.6 for SE- strain ratio, respectively. Diagnostic accuracy was 71% for both strain value and strain ratio of nodules.

Conclusions: SE as an additional ultrasound tool improves the value of ultrasound for the work-up of thyroid nodules. It might reduce diagnostic surgery of thyroid nodules in the future.