J Surg Ultrasound.  2021 May;8(1):1-5. 10.46268/jsu.2021.8.1.1.

Diagnosis of Thyroid Nodules by Elastography

Affiliations
  • 1Division of BreastㆍThyroid Surgery, Department of Surgery, Jeonbuk National University Medical School, Jeonju, Korea

Abstract

Ultrasonography is mandatory for the evaluation of thyroid nodules. Although B-mode and Doppler ultrasonography are both sensitive for the diagnosis of thyroid lesions, they lack specificity in differentiating benign from malignant nodules. Elastography has been described as an accurate predictor of malignancy by determining tissue elasticity. There are several methods utilized to evaluate the stiffness of normal tissue and the thyroid nodule, such as strain elastography, acoustic radiation force impulse, and shear wave elastography. Many studies show that elastography has both high sensitivity and specificity that approaches 100% for the determination of thyroid carcinoma. In addition, elastography also has a very high negative predictive value and thus, may also be helpful in the identification of thyroid nodules that do not need further diagnostic evaluation, including fine needle aspiration cytology. However, in the light of current evidence, there is a need for standardization and consensus on the most optimum elastography acquisition process. The purpose of this review is to provide a comprehensive summary of the use of elastography in the evaluation of thyroid nodules.

Keyword

Ultrasonography; Elasticity imaging techniques; Thyroid nodule; Carcinoma

Figure

  • Fig. 1 Ultrasound elastography techniques. (A) Strain elastography. (B) Acoustic radiation force impulse. (C) Shear wave elastography.


Reference

1. Guth S, Theune U, Aberle J, Galach A, Bamberger CM. 2009; Very high prevalence of thyroid nodules detected by high frequency (13 MHz) ultrasound examination. Eur J Clin Invest. 39:699–706. DOI: 10.1111/j.1365-2362.2009.02162.x. PMID: 19601965.
Article
2. Hegedus L. 2004; Clinical practice. The thyroid nodule. N Engl J Med. 351:1764–71. DOI: 10.1056/NEJMcp031436. PMID: 15496625.
3. Cancer today: data visualization tools for exploring the global cancer burden in 2020 [Internet]. International Agency for Research on Cancer;Lyon: Available from: http://gco.iarc.fr/today/home. cited 2021 Mar 22.
4. National Cancer Information Center [Internet]. National Cancer Information Center;Goyang: Available from: https://www.cancer.go.kr. cited 2021 Mar 22.
5. Carneiro-Pla D. 2013; Ultrasound elastography in the evaluation of thyroid nodules for thyroid cancer. Curr Opin Oncol. 25:1–5. DOI: 10.1097/CCO.0b013e32835a87c8. PMID: 23211839.
Article
6. Chammas MC, Gerhard R, de Oliveira IR, Widman A, de Barros N, Durazzo M, et al. 2005; Thyroid nodules: evaluation with power Doppler and duplex Doppler ultrasound. Otolaryngol Head Neck Surg. 132:874–82. DOI: 10.1016/j.otohns.2005.02.003. PMID: 15944558.
Article
7. Russ G, Bigorgne C, Royer B, Rouxel A, Bienvenu-Perrard M. 2011; [The Thyroid Imaging Reporting and Data System (TIRADS) for ultrasound of the thyroid]. J Radiol. 92:701–13. French. DOI: 10.1016/j.jradio.2011.03.022. PMID: 21819912.
8. Monpeyssen H, Tramalloni J, Poirée S, Hélénon O, Correas JM. 2013; Elastography of the thyroid. Diagn Interv Imaging. 94:535–44. DOI: 10.1016/j.diii.2013.01.023. PMID: 23623210.
Article
9. Shuzhen C. 2012; Comparison analysis between conventional ultrasonography and ultrasound elastography of thyroid nodules. Eur J Radiol. 81:1806–11. DOI: 10.1016/j.ejrad.2011.02.070. PMID: 21962937.
Article
10. Merino S, Arrazola J, Cárdenas A, Mendoza M, De Miguel P, Fernández C, et al. 2011; Utility and interobserver agreement of ultrasound elastography in the detection of malignant thyroid nodules in clinical care. AJNR Am J Neuroradiol. 32:2142–8. DOI: 10.3174/ajnr.A2716. PMID: 22051809. PMCID: PMC7964425.
Article
11. Ragazzoni F, Deandrea M, Mormile A, Ramunni MJ, Garino F, Magliona G, et al. 2012; High diagnostic accuracy and interobserver reliability of real-time elastography in the evaluation of thyroid nodules. Ultrasound Med Biol. 38:1154–62. DOI: 10.1016/j.ultrasmedbio.2012.02.025. PMID: 22542262.
Article
12. Ophir J, Céspedes I, Ponnekanti H, Yazdi Y, Li X. 1991; Elastography: a quantitative method for imaging the elasticity of biological tissues. Ultrason Imaging. 13:111–34. DOI: 10.1177/016173469101300201. PMID: 1858217.
Article
13. Magri F, Chytiris S, Chiovato L. 2016; The role of elastography in thyroid ultrasonography. Curr Opin Endocrinol Diabetes Obes. 23:416–22. DOI: 10.1097/MED.0000000000000274. PMID: 27428520.
Article
14. Asteria C, Giovanardi A, Pizzocaro A, Cozzaglio L, Morabito A, Somalvico F, et al. 2008; US-elastography in the differential diagnosis of benign and malignant thyroid nodules. Thyroid. 18:523–31. DOI: 10.1089/thy.2007.0323. PMID: 18466077.
Article
15. Rago T, Vitti P, Chiovato L, Mazzeo S, De Liperi A, Miccoli P, et al. 1998; Role of conventional ultrasonography and color flow-doppler sonography in predicting malignancy in 'cold' thyroid nodules. Eur J Endocrinol. 138:41–6. DOI: 10.1530/eje.0.1380041. PMID: 9461314.
Article
16. Bojunga J, Herrmann E, Meyer G, Weber S, Zeuzem S, Friedrich-Rust M. 2010; Real-time elastography for the differentia-tion of benign and malignant thyroid nodules: a meta-analysis. Thyroid. 20:1145–50. DOI: 10.1089/thy.2010.0079. PMID: 20860422.
Article
17. Moon HJ, Sung JM, Kim EK, Yoon JH, Youk JH, Kwak JY. 2012; Diagnostic performance of gray-scale US and elastography in solid thyroid nodules. Radiology. 262:1002–13. DOI: 10.1148/radiol.11110839. PMID: 22357900.
Article
18. Azizi G, Keller JM, Mayo ML, Piper K, Puett D, Earp KM, et al. 2015; Thyroid nodules and shear wave elastography: a new tool in thyroid cancer detection. Ultrasound Med Biol. 41:2855–65. DOI: 10.1016/j.ultrasmedbio.2015.06.021. PMID: 26277203.
Article
19. Moraes PHM, Sigrist R, Takahashi MS, Schelini M, Chammas MC. 2019; Ultrasound elastography in the evaluation of thyroid nodules: evolution of a promising diagnostic tool for predicting the risk of malignancy. Radiol Bras. 52:247–53. DOI: 10.1590/0100-3984.2018.0084. PMID: 31435087. PMCID: PMC6696751.
Article
20. Bamber J, Cosgrove D, Dietrich CF, Fromageau J, Bojunga J, Calliada F, et al. 2013; EFSUMB guidelines and recommendations on the clinical use of ultrasound elastography. Part 1: basic principles and technology. Ultraschall Med. 34:169–84. DOI: 10.1055/s-0033-1335205. PMID: 23558397.
Article
21. Cosgrove D, Piscaglia F, Bamber J, Bojunga J, Correas JM, Gilja OH, et al. 2013; EFSUMB guidelines and recommendations on the clinical use of ultrasound elastography. Part 2: clinical applications. Ultraschall Med. 34:238–53. DOI: 10.1055/s-0033-1335375. PMID: 23605169.
22. Friedrich-Rust M, Romenski O, Meyer G, Dauth N, Holzer K, Grünwald F, et al. 2012; Acoustic radiation force impulse-imaging for the evaluation of the thyroid gland: a limited patient feasibility study. Ultrasonics. 52:69–74. DOI: 10.1016/j.ultras.2011.06.012. PMID: 21788057.
Article
23. Bojunga J, Dauth N, Berner C, Meyer G, Holzer K, Voelkl L, et al. 2012; Acoustic radiation force impulse imaging for differentiation of thyroid nodules. PLoS One. 7:e42735. DOI: 10.1371/journal.pone.0042735. PMID: 22952609. PMCID: PMC3430659.
Article
24. Gu J, Du L, Bai M, Chen H, Jia X, Zhao J, et al. 2012; Preliminary study on the diagnostic value of acoustic radiation force impulse technology for differentiating between benign and malignant thyroid nodules. J Ultrasound Med. 31:763–71. DOI: 10.7863/jum.2012.31.5.763. PMID: 22535724.
Article
25. Dong FJ, Li M, Jiao Y, Xu JF, Xiong Y, Zhang L, et al. 2015; Acoustic radiation force impulse imaging for detecting thyroid nodules: a systematic review and pooled meta-analysis. Med Ultrason. 17:192–9. DOI: 10.11152/mu.2013.2066.172.hyr. PMID: 26052570.
Article
26. Zhao CK, Xu HX. 2019; Ultrasound elastography of the thyroid: principles and current status. Ultrasonography. 38:106–24. DOI: 10.14366/usg.18037. PMID: 30690960. PMCID: PMC6443591.
Article
27. Sebag F, Vaillant-Lombard J, Berbis J, Griset V, Henry JF, Petit P, et al. 2010; Shear wave elastography: a new ultrasound imaging mode for the differential diagnosis of benign and malignant thyroid nodules. J Clin Endocrinol Metab. 95:5281–8. DOI: 10.1210/jc.2010-0766. PMID: 20881263.
Article
28. Veyrieres JB, Albarel F, Lombard JV, Berbis J, Sebag F, Oliver C, et al. 2012; A threshold value in Shear Wave elastography to rule out malignant thyroid nodules: a reality? Eur J Radiol. 81:3965–72. DOI: 10.1016/j.ejrad.2012.09.002. PMID: 23031543.
Article
29. Kim H, Kim JA, Son EJ, Youk JH. 2013; Quantitative assessment of shear-wave ultrasound elastography in thyroid nodules: diagnostic performance for predicting malignancy. Eur Radiol. 23:2532–7. DOI: 10.1007/s00330-013-2847-5. PMID: 23604801.
Article
30. Kim HJ, Kwak MK, Choi IH, Jin SY, Park HK, Byun DW, et al. 2019; Utility of shear wave elastography to detect papillary thyroid carcinoma in thyroid nodules: efficacy of the standard deviation elasticity. Korean J Intern Med. 34:850–7. DOI: 10.3904/kjim.2016.326. PMID: 29466846. PMCID: PMC6610177.
Article
31. Liu Z, Jing H, Han X, Shao H, Sun YX, Wang QC, et al. 2017; Shear wave elastography combined with the thyroid imaging reporting and data system for malignancy risk stratification in thyroid nodules. Oncotarget. 8:43406–16. DOI: 10.18632/oncotarget.15018. PMID: 28160573. PMCID: PMC5522156.
Article
32. Duan SB, Yu J, Li X, Han ZY, Zhai HY, Liang P. 2016; Diagnostic value of two-dimensional shear wave elastography in papillary thyroid microcarcinoma. Onco Targets Ther. 9:1311–7. DOI: 10.2147/OTT.S98583. PMID: 27022286. PMCID: PMC4790519.
33. Dobruch-Sobczak K, Guminska A, Bakuła-Zalewska E, Mlosek K, Słapa RZ, Wareluk P, et al. 2015; Shear wave elastography in medullary thyroid carcinoma diagnostics. J Ultrason. 15:358–67. DOI: 10.15557/JoU.2015.0033. PMID: 26807293. PMCID: PMC4710687.
34. Xu HX, Yan K, Liu BJ, Liu WY, Tang LN, Zhou Q, et al. 2019; Guidelines and recommendations on the clinical use of shear wave elastography for evaluating thyroid nodule1. Clin Hemorheol Microcirc. 72:39–60. DOI: 10.3233/CH-180452. PMID: 30320562.
Article
35. Kanagaraju V, Rakshith AVB, Devanand B, Rajakumar R. 2019; Utility of ultrasound elastography to differentiate benign from malignant cervical lymph nodes. J Med Ultrasound. 28:92–8. DOI: 10.4103/JMU.JMU_72_19. PMID: 32874867. PMCID: PMC7446693.
Article
36. Han RJ, Du J, Li FH, Zong HR, Wang JD, Shen YL, et al. 2019; Comparisons and combined application of two-dimensional and three-dimensional real-time shear wave elastography in diagnosis of thyroid nodules. J Cancer. 10:1975–84. DOI: 10.7150/jca.30135. PMID: 31205557. PMCID: PMC6548166.
Article
Full Text Links
  • JSU
Actions
Cited
CITED
export Copy
Close
Share
  • Twitter
  • Facebook
Similar articles
Copyright © 2024 by Korean Association of Medical Journal Editors. All rights reserved.     E-mail: koreamed@kamje.or.kr