E2807. Differentiation of Malignant Thyroid Nodules Using Vascularity and
Elastographic Assessments in Suspicious TIRADS Scores
Authors
Leila Aghaghazvini;
Shariati hospital, Tehran University of Medical Sciences
Mohadeseh Tohidi;
Advanced Diagnostic and Interventional Radiology Research Center (ADIR), Tehran University of Medical Sciences
Madjid Shakiba;
Advanced Diagnostic and Interventional Radiology Research Center (ADIR), Tehran University of Medical Sciences
Ario Mohammadi;
Advanced Diagnostic and Interventional Radiology Research Center (ADIR), Tehran University of Medical Sciences
Mahsa Alborzi Avanaki ;
Advanced Diagnostic and Interventional Radiology Research Center (ADIR), Tehran University of Medical Sciences
Nesa Shahbazifar;
Advanced Diagnostic and Interventional Radiology Research Center (ADIR), Tehran University of Medical Sciences
Objective:
Sonographic TIRADS scoring is the first imaging assessment method for diagnosing malignant thyroid nodules, but it could be improved by adding other assessments. In this study, we assessed the added value of vascularity and elastographic assessments (shear wave elastography, SWE) to classic TIRADS assessment.
Materials and Methods:
A total of 200 thyroid nodules were assessed by conventional sonography to determine TIRADS score and its descriptors. Vascularity pattern and resistive index (RI) were assessed by a 7.5 MHz probe. Elastography assessment was performed qualitatively by assessment of color mapping and quantitatively by calculating mean and maximum velocity in shear wave modality. Final diagnosis of all nodules was confirmed by histopathology assessment or follow up imaging.
Results:
Mean age of patients was 53 ± 9.2 years [36 - 68] and 105 were men [52.5%]. 27 nodules were malignant [13.5%] (14 were PTC [7%], 11 were FTC [5.5%] and 2 were MTC [1%]). AUC of the ROC curve for TIRADS assessment was 0.76. We had 37 [18.5%] TIRADS 4 nodules of which 15 [40.5% of TIRADS 4 nodules] were malignent and 57 TIRADS 5 [28.5%] nodules of which 12 [21.1% of TIRADS 5 nodules] were malignant. In only TIRADS 4 nodules, AUC of Doppler grade, RI, color map grade of elastography, maximum velocity of SWE, and mean velocity of SWE in diagnosing malignancy were 0.8, 0.93, 0.89, 0.86 and 0.82, respectively while this profile in only TIRADS 5 nodules were 0.8, 0.96, 0.85, 0.96 and 0.97 respectively. In TIRADS 4, a cutoff point of 0.6 for RI yielded diagnostic efficacy indices of 0.93, 1, 0.97, 1, and 0.96 for sensitivity, specificity, efficiency, PPV and NPV, respectively. In TIRADS 5 nodules, a cutoff point of 4.33 for SWE mean velocity yielded diagnostic efficacy indices of 1, 0.82, 0.86, 0.6 and 1 for sensitivity, specificity, efficiency, PPV and NPV, respectively.
Conclusion:
Vascularity and elastography assessments in suspicious TIRADS categories could efficiently diagnose malignancy of thyroid nodules.
