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DOI: 10.1055/s-0036-1587890
Does Shear Wave Elastography (SWE) parameters improve the differentiation the character of the thyroid lesions
The aims of study were to determine whether shear wave elastography (SWE) can improve the B-mode differentiation of thyroid lesions, determine the most accurate SWE parameter for differentiation, and assess the influence of microcalcifications (MCs) and chronic autoimmune thyroiditis (CAT) on SWE values. We examined 119 patients with 169 thyroid nodules who prospectively underwent B-mode US and SWE using the same US machine. The following parameters were assessed using SWE: mean elasticity within the entire lesion (SWE-whole) and the mean (SWE-mean) and maximum elasticities (SWE-max) for a 2-mm region of interest (ROI) in the stiffest portion of the lesion, excluding MCs. The discriminant powers of a GEE model including B-mode only and both B-mode and SWE parameters were assessed and compared using the area under the ROC curve (AUC), in association with pathological verifications. In total, 50 and 119 malignant and benign lesions were detected. Multivariate logistic regression analysis for B-mode parameters revealed that MCs [odds ratio (OR), 4.3, hypoechogenicity (OR, 3.13, and irregular margins (OR, 10.82) were associated with a higher OR for malignancy, while that for SWE parameters revealed that SWE-max was an independent parameter for the same (OR, 2.95). The AUC for the B-mode model was 0.85, while that for the model combining B-mode and SWE parameters was 0.87. There was no significant difference in the mean SWE values between patients with and without CAT.
The results of the present study suggest that SWE is a valuable tool for the characterization of thyroid nodules, with SWE-max being a significant parameter to differentiate benign and malignant lesions, independent of conventional B-mode parameters. The combination of SWE parameters and conventional B-mode parameters does not significantly improve the diagnosis of malignant thyroid nodules. The presence of MCs can influence the SWE-whole value, while the presence of CAT may not.