Comparative evaluation of ultrasound strain elastography and diffusion weighted magnetic resonance imaging in differentiating malignant from benign thyroid nodules

Introduction: A common thyroid gland disorder is thyroid nodules. The key to successfully treating malignant thyroid nodular lesions is an early, expert, and accurate diagnosis. Aim of the study: To distinguish between benign and malignant thyroid nodular lesions by comparing the diagnostic performance of quantitative diffusion-weighted MRI, elastic score, TI-RADS, and strain ratio. Subjects and Methods: The current prospective study recruited 59 individuals with Thyroid nodular lesions. All patients were assessed by conventional ultrasonography, ultrasonic strain elastography (elasticity score + strain ratio), ADC value, and diffusion-weighted magnetic resonance imaging. The results of the histology were typical. Result: The TI-RADS score was 84.9% accurate, 89.8% specific, and 80% sensitive. An elasticity score with a cutoff value of 3 had (91.8%) specificity, (70% sensitivity), and (80.9%) accuracy using Asteria's 4-point criterion. When a strain ratio cutoff value of 1.65 was chosen, there were significant improvements in diagnostic accuracy (91.8%), sensitivity (90%), and specificity (71.4%). It was found that (95.9%) represents specificity, (80%) sensitivity, and overall accuracy determined with (98%) were observed For the ADC value, the cutoff value of 1.45 x 10-03 was used. Multi-parametric analysis improved the sharpness of TI-RADS grading in our experiment. By combining the ADC diffusion value with the TI-RADS rating, which had specificity of 95.9%, sensitivity of 100%, and accuracy of 98%, the best diagnostic approach was achieved. Conclusion: both strain ratio and the value of ADC diffusion performed accurately, while the US TI-RADS rating for describing thyroid nodular lesions was not of the same accuracy. The greatest performance for reaching diagnosis in this investigation was produced by the combination of the ADC diffusion value with the TI-RADS rating, with a general accuracy of about 98%.