Role of Ultrasound Elastography in Differentiating Benign and Malignant Thyroid Nodules

Abduljabbar A. Abbood

doi:10.51699/7mneks45

Authors

Abduljabbar A. Abbood Department of Radiology, College of medicine, Tikrit University, Tikrit, Iraq

DOI:

https://doi.org/10.51699/7mneks45

Keywords:

Thyroid nodules, Ultrasound elastography, Shear wave elastography, Strain elastography, Thyroid cancer

Abstract

In clinical practice, thyroid nodules are among the most prevalent endocrine disorders: Context. Although most nodules are benign, it may be difficult to distinguish between benign and malignant nodules prior to surgery. Ultrasound elastography is a new imaging method that may be used to detect tissue stiffness and is thought to improve the effectiveness of traditional ultrasonography. This research aimed to evaluate the accuracy of using ultrasonic elastography in combination with a traditional ultrasound examination to distinguish between benign and malignant thyroid nodules. From Jan. 2024 to Jan. 2025, prospective cross-sectional research was carried out at the Tikrit Teaching Hospital in Tikrit City, Iraq. Ninety individuals with thyroid nodules of all sexes and ages ranging from 25 to 65 were included. On a high-resolution ultrasound equipment equipped with elastography software, each participant underwent the standard B-mode ultrasound, color Doppler imaging, strain elastography, and shear wave elastography procedures. Elasticity score, strain ratio, and shear wave elasticity value are examples of elastographic parameters that have been measured, analyzed, and compared with cytopathological and histopathological findings that served as the reference standard. Using SPSS 27, the data was statistically analyzed, and diagnostic performance indexes were computed. Every thyroid nodule was either cancerous (27, 30.0%) or benign (63, 70.0%). Malignant nodules had considerably greater strain ratios, elasticity scores, and shear wave elasticity values than benign nodules (p < 0.001). Hypoechogenicity, uneven edges, microcalcifications, taller than broad form, and enhanced intranodular vascularity were the traditional ultrasonic characteristics linked to malignancy. Ultrasound elastography had an overall diagnostic accuracy of 91.1%, an area under the receiver operating characteristic curve of 0.951, and sensitivity, specificity, positive, and negative predictive values of 92.6%, 90.5%, 81.0%, and 96.6%, respectively. When conventional ultrasonography and elastography were used together, the total diagnosis accuracy rose to 94.4%. One practical and efficient use of ultrasound as an auxiliary imaging technique to help distinguish between benign and malignant thyroid nodules is ultrasound elastography. The combination of imaging methods is expected to increase the number of patients receiving surgical treatment, increase diagnostic accuracy, and perhaps decrease the number of needless FNA biopsies. Risk assessment and clinical decision-making may be enhanced by the regular ultrasonography examination of the thyroid using elastography.

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