The additive value of real-time elastography to thyroid ultrasound in detecting papillary carcinoma in nodules over 20 mm in diameter.

IF 3 3区医学 Q2 ENDOCRINOLOGY & METABOLISM

Endocrine Pub Date : 2025-04-24 DOI:10.1007/s12020-025-04248-1

Nikolaos Angelopoulos, Dimitrios G Goulis, Ioannis Chrisogonidis, Sarantis Livadas, Rodis D Paparodis, Ioannis Androulakis, Juan Carlos Jaume, Ioannis Iakovou

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引用次数: 0

Abstract

Purpose: Ultrasonography (US) is the most accurate and cost-effective imaging method for identifying thyroid nodules. The difficulty in determining which nodules to sample for fine-needle aspiration (FNA) cytology has prompted the introduction of the Thyroid Imaging Reporting and Data Systems (TIRADS), which assesses the malignancy risk associated with thyroid nodules. Real-time elastography (RTE), coupled with strain ratio (SR) measurements, offers a means to evaluate the nodule stiffness and potentially discern their likelihood of being malignant. The present study aimed to investigate the efficacy of RTE and SR, combined with the TIRADS grading systems, in distinguishing between benign and malignant thyroid nodules.

Methods: From 1094 patients with thyroid nodules referred for thyroid ultrasound at a University Hospital, those with thyroid nodules ≥20 mm in diameter were enrolled. Each nodule was categorized according to European (EU)- and American College of Radiology (ACR)-TIRADS systems, ranging from 2-5. Nodules' SRs were evaluated together with RTE. The thyroid nodule diagnosis was documented by post-thyroidectomy histopathological examination and/or US-guided FNA according to the Bethesda classification of the examined smears.

Results: The study involved 267 patients (mean age 60.3 ± 14.3 years; 46 males and 221 females) with 308 nodules categorized into EU-TIRADS categories 3, 4, and 5. Of these nodules, 22 proved malignant, and 286 benign. The elastography ratio exhibited high predictive performance in diagnosing thyroid malignancy (p < 0.001) at a threshold value of >0.84 (sensitivity 90.9%, specificity 73.4%). In the 168 nodules with EU-TIRADS 3, this threshold had 100% sensitivity and 75.1% specificity in discriminating malignant thyroid nodules.

Conclusion: Combining TIRADS with data derived from RTE reduces unnecessary FNAs and surgeries in patients with thyroid nodular disease.

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实时弹性成像对甲状腺超声检测直径大于20mm的乳头状癌的附加价值。

目的：超声检查（US）是诊断甲状腺结节最准确、最经济的影像学方法。由于难以确定细针穿刺（FNA）细胞学检查的结节样本，因此引入了甲状腺成像报告和数据系统（TIRADS），该系统评估与甲状腺结节相关的恶性肿瘤风险。实时弹性成像（RTE）与应变比（SR）测量相结合，提供了一种评估结节刚度的方法，并有可能识别其恶性的可能性。本研究旨在探讨RTE和SR结合TIRADS分级系统在区分甲状腺结节良恶性方面的疗效。方法：选取1094例在某大学附属医院行甲状腺超声检查的甲状腺结节患者，其中甲状腺结节直径≥20mm者为研究对象。每个结节根据欧洲（EU）和美国放射学会(ACR)- tirads系统进行分类，范围从2-5。结节的SRs与RTE一起评估。甲状腺结节的诊断通过甲状腺切除术后的组织病理学检查和/或根据检查的涂片的Bethesda分类进行us引导的FNA记录。结果：研究纳入267例患者(平均年龄60.3±14.3岁；46名男性和221名女性)，308个结节被归类为EU-TIRADS第3、4和5类。22例为恶性结节，286例为良性结节。弹性成像比值对甲状腺恶性肿瘤的诊断具有较高的预测价值（p = 0.84，敏感性90.9%，特异性73.4%）。在168例EU-TIRADS 3结节中，该阈值鉴别甲状腺恶性结节的敏感性为100%，特异性为75.1%。结论：将TIRADS与RTE数据相结合，可减少甲状腺结节病患者不必要的FNAs和手术。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Endocrine ENDOCRINOLOGY & METABOLISM-

CiteScore

6.50

自引率

5.40%

发文量

295

审稿时长

1.5 months

期刊介绍： Well-established as a major journal in today’s rapidly advancing experimental and clinical research areas, Endocrine publishes original articles devoted to basic (including molecular, cellular and physiological studies), translational and clinical research in all the different fields of endocrinology and metabolism. Articles will be accepted based on peer-reviews, priority, and editorial decision. Invited reviews, mini-reviews and viewpoints on relevant pathophysiological and clinical topics, as well as Editorials on articles appearing in the Journal, are published. Unsolicited Editorials will be evaluated by the editorial team. Outcomes of scientific meetings, as well as guidelines and position statements, may be submitted. The Journal also considers special feature articles in the field of endocrine genetics and epigenetics, as well as articles devoted to novel methods and techniques in endocrinology. Endocrine covers controversial, clinical endocrine issues. Meta-analyses on endocrine and metabolic topics are also accepted. Descriptions of single clinical cases and/or small patients studies are not published unless of exceptional interest. However, reports of novel imaging studies and endocrine side effects in single patients may be considered. Research letters and letters to the editor related or unrelated to recently published articles can be submitted. Endocrine covers leading topics in endocrinology such as neuroendocrinology, pituitary and hypothalamic peptides, thyroid physiological and clinical aspects, bone and mineral metabolism and osteoporosis, obesity, lipid and energy metabolism and food intake control, insulin, Type 1 and Type 2 diabetes, hormones of male and female reproduction, adrenal diseases pediatric and geriatric endocrinology, endocrine hypertension and endocrine oncology.