The value of quantitative and a new qualitative color pattern shear wave elastography for the differentiation of ACR TI-RADS 4 or 5 category thyroid nodules measuring ≤10 mm

Ai-Jiao Yi; Wei-Wei Yang; Xin-Wu Cui; Christoph F Dietrich; Bin Wang

doi:10.3389/fendo.2023.1275256

The value of quantitative and a new qualitative color pattern shear wave elastography for the differentiation of ACR TI-RADS 4 or 5 category thyroid nodules measuring ≤10 mm

Front Endocrinol (Lausanne). 2024 Jan 8:14:1275256. doi: 10.3389/fendo.2023.1275256. eCollection 2023.

Authors

Ai-Jiao Yi^#¹, Wei-Wei Yang^#¹, Xin-Wu Cui², Christoph F Dietrich³, Bin Wang¹

Affiliations

¹ Department of medical ultrasound, Yueyang Central Hospital, Yueyang, China.
² Department of Medical Ultrasound, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
³ Department Allgemeine Innere Medizin, Kliniken Hirslanden Beau Site, Salem und Permanence, Bern, Switzerland.

^# Contributed equally.

Abstract

Objective: This study aims to evaluate the diagnostic performance of quantitative shear wave elastography (SWE) and a new qualitative color pattern SWE for the differentiation of benign and malignant American College of Radiology Thyroid Imaging, Reporting, and Data System (ACR TI-RADS) 4 or 5 category thyroid nodules measuring ≤10 mm.

Materials and methods: From May 2020 to July 2022, a total of 237 patients with 270 thyroid nodules were enrolled, and conventional ultrasound and SWE examinations were performed for each patient. Each ACR TI-RADS 4 or 5 category thyroid nodule measuring ≤10 mm was evaluated by quantitative SWE and a new qualitative color pattern SWE. The diagnostic performance of quantitative SWE parameters, the new qualitative color pattern SWE, and the combination of SWE with ACR TI-RADS, respectively, for the differentiation of benign and malignant ACR TI-RADS 4 or 5 category thyroid nodules measuring ≤10 mm was evaluated and compared.

Results: Among 270 thyroid nodules in 237 patients, 72 (26.67%) thyroid nodules were benign and 198 (73.33%) thyroid nodules were malignant. The qualitative color pattern SWE showed better diagnostic performance than the quantitative SWE parameters. When combining the qualitative color pattern SWE with ACR TI-RADS scores, with the optimal cutoff value of the total points ≥8, the thyroid nodules were considered malignant. The sensitivity, specificity, accuracy, and AUC were 89.90%, 56.94%, 81.11%, and 0.820 (95% CI: 0.768-0.864), respectively. Compared with using qualitative color pattern SWE alone, the combination of qualitative color pattern SWE and ACR TI-RADS had better diagnostic performance, which was significantly different (p < 0.05).

Conclusion: The combination of qualitative SWE color patterns and ACR TI-RADS had high sensitivity and accuracy, which might be a convenient and useful method to differentiate benign and malignant ACR TI-RADS 4 or 5 category thyroid nodules measuring ≤10 mm. It would be helpful for the management of thyroid nodules and improving prognosis.

Keywords: ACR TI-RADS; color pattern; shear wave elastography; thyroid nodule; ultrasonography.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Elasticity Imaging Techniques*
Humans
Thyroid Nodule* / diagnostic imaging

Grants and funding

The author(s) declare financial support was received for the research, authorship, and/or publication of this article. This work was supported by the general funding project of Hunan Provincial Health Commission (no. B202309029532) and the Natural Science Foundation of Hunan Province (no. 2023JJ50304).