Role of ultrasonography and ultrasound elastography in the evaluation of thyroid nodules

Muthiah Nachiappan, Vinaya Poornima, Ashvini Kumar, Sonali D. Prabhu, Ravi Raj Singh Chouhan

Research output: Contribution to journalArticle

Abstract

Introduction: Thyroid nodules are frequently encountered with its Incidence is increasing steadily. Most nodules are benign and <5% of nodules are malignant. High-Resolution Ultrasonography (HRUS) is the most sensitive imaging test available for the examination of the thyroid gland to detect thyroid lesions accurately. Ultrasonography (US) is relatively cheap, easily accessible, rapidly performed and has an advantage of no exposure to ionising radiation. Sonoelastography (SE) is a relatively new non-invasive technique for imaging stiffness or elasticity of the tissue by measuring movement or deformation of tissue in response to a small applied pressure. Aim: To assess the diagnostic performance of conventional ultrasonography, colour mapping and strain ratio using SE for characterising thyroid nodules. Materials and Methods: A prospective study was conducted from October 2015 to August 2017 in which 65 patients were examined. All age group patients who were referred for thyroid ultrasonography and detected to have a thyroid nodule which was subsequently confirmed by FNA/histopathology were included in the study. Test of significance was assessed using the chi-square test, p<0.05 was considered significant. Results: FNA/HPE revealed 14 (21.5%) malignant (six papillary carcinomas, three poorly differentiated carcinoma, two anaplastic carcinomas and three follicular carcinomas) and 51 (78.5%) benign nodules. Out of these 14, 13 (92.9%) cases were found in patients above 50 years and only 1 (7.1%) case was found below 50 years. Calculation of strain ratio was done between the thyroid nodule and the surrounding thyroid tissue at the same depth. Significant differences were seen between the strain ratios for the benign and malignant lesions (p<.001). By using ultrasound elastography score malignancy was seen in 81.3% of malignant nodules. Conclusion: Ultrasonography is a cost-effective modality of imaging and also the investigation of choice in thyroid nodules. Elastography has proven to be a good adjunct tool in assisting USG in the diagnosis and differentiation of benign versus malignant nodules.

Original languageEnglish
Pages (from-to)TC13-TC17
JournalJournal of Clinical and Diagnostic Research
Volume12
Issue number12
DOIs
Publication statusPublished - 01-12-2018

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Ultrasonography
Elasticity Imaging Techniques
Thyroid Nodule
Ultrasonics
Thyroid Gland
Tissue
Carcinoma
Imaging techniques
Papillary Carcinoma
Ionizing radiation
Elasticity
Chi-Square Distribution
Ionizing Radiation
Age Groups
Color
Stiffness
Prospective Studies
Pressure
Costs and Cost Analysis
Incidence

All Science Journal Classification (ASJC) codes

  • Clinical Biochemistry

Cite this

Nachiappan, Muthiah ; Poornima, Vinaya ; Kumar, Ashvini ; Prabhu, Sonali D. ; Chouhan, Ravi Raj Singh. / Role of ultrasonography and ultrasound elastography in the evaluation of thyroid nodules. In: Journal of Clinical and Diagnostic Research. 2018 ; Vol. 12, No. 12. pp. TC13-TC17.
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abstract = "Introduction: Thyroid nodules are frequently encountered with its Incidence is increasing steadily. Most nodules are benign and <5{\%} of nodules are malignant. High-Resolution Ultrasonography (HRUS) is the most sensitive imaging test available for the examination of the thyroid gland to detect thyroid lesions accurately. Ultrasonography (US) is relatively cheap, easily accessible, rapidly performed and has an advantage of no exposure to ionising radiation. Sonoelastography (SE) is a relatively new non-invasive technique for imaging stiffness or elasticity of the tissue by measuring movement or deformation of tissue in response to a small applied pressure. Aim: To assess the diagnostic performance of conventional ultrasonography, colour mapping and strain ratio using SE for characterising thyroid nodules. Materials and Methods: A prospective study was conducted from October 2015 to August 2017 in which 65 patients were examined. All age group patients who were referred for thyroid ultrasonography and detected to have a thyroid nodule which was subsequently confirmed by FNA/histopathology were included in the study. Test of significance was assessed using the chi-square test, p<0.05 was considered significant. Results: FNA/HPE revealed 14 (21.5{\%}) malignant (six papillary carcinomas, three poorly differentiated carcinoma, two anaplastic carcinomas and three follicular carcinomas) and 51 (78.5{\%}) benign nodules. Out of these 14, 13 (92.9{\%}) cases were found in patients above 50 years and only 1 (7.1{\%}) case was found below 50 years. Calculation of strain ratio was done between the thyroid nodule and the surrounding thyroid tissue at the same depth. Significant differences were seen between the strain ratios for the benign and malignant lesions (p<.001). By using ultrasound elastography score malignancy was seen in 81.3{\%} of malignant nodules. Conclusion: Ultrasonography is a cost-effective modality of imaging and also the investigation of choice in thyroid nodules. Elastography has proven to be a good adjunct tool in assisting USG in the diagnosis and differentiation of benign versus malignant nodules.",
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Role of ultrasonography and ultrasound elastography in the evaluation of thyroid nodules. / Nachiappan, Muthiah; Poornima, Vinaya; Kumar, Ashvini; Prabhu, Sonali D.; Chouhan, Ravi Raj Singh.

In: Journal of Clinical and Diagnostic Research, Vol. 12, No. 12, 01.12.2018, p. TC13-TC17.

Research output: Contribution to journalArticle

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T1 - Role of ultrasonography and ultrasound elastography in the evaluation of thyroid nodules

AU - Nachiappan, Muthiah

AU - Poornima, Vinaya

AU - Kumar, Ashvini

AU - Prabhu, Sonali D.

AU - Chouhan, Ravi Raj Singh

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AB - Introduction: Thyroid nodules are frequently encountered with its Incidence is increasing steadily. Most nodules are benign and <5% of nodules are malignant. High-Resolution Ultrasonography (HRUS) is the most sensitive imaging test available for the examination of the thyroid gland to detect thyroid lesions accurately. Ultrasonography (US) is relatively cheap, easily accessible, rapidly performed and has an advantage of no exposure to ionising radiation. Sonoelastography (SE) is a relatively new non-invasive technique for imaging stiffness or elasticity of the tissue by measuring movement or deformation of tissue in response to a small applied pressure. Aim: To assess the diagnostic performance of conventional ultrasonography, colour mapping and strain ratio using SE for characterising thyroid nodules. Materials and Methods: A prospective study was conducted from October 2015 to August 2017 in which 65 patients were examined. All age group patients who were referred for thyroid ultrasonography and detected to have a thyroid nodule which was subsequently confirmed by FNA/histopathology were included in the study. Test of significance was assessed using the chi-square test, p<0.05 was considered significant. Results: FNA/HPE revealed 14 (21.5%) malignant (six papillary carcinomas, three poorly differentiated carcinoma, two anaplastic carcinomas and three follicular carcinomas) and 51 (78.5%) benign nodules. Out of these 14, 13 (92.9%) cases were found in patients above 50 years and only 1 (7.1%) case was found below 50 years. Calculation of strain ratio was done between the thyroid nodule and the surrounding thyroid tissue at the same depth. Significant differences were seen between the strain ratios for the benign and malignant lesions (p<.001). By using ultrasound elastography score malignancy was seen in 81.3% of malignant nodules. Conclusion: Ultrasonography is a cost-effective modality of imaging and also the investigation of choice in thyroid nodules. Elastography has proven to be a good adjunct tool in assisting USG in the diagnosis and differentiation of benign versus malignant nodules.

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