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Vol. 58. Issue 5.
Pages 366-372 (September - October 2016)
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Vol. 58. Issue 5.
Pages 366-372 (September - October 2016)
Original Report
Usefulness of semiquantitative elastography in predicting malignancy in thyroid nodules
Utilidad de la elastografía semicuantitativa para predecir la malignidad de los nódulos tiroideos
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C. Franco Uliaquea,
Corresponding author
caroluliaque@hotmail.com

Corresponding author.
, F.J. Pardo Berdúna, R. Laborda Herrerob, C. Pérez Lórenza
a Servicio de Radiodiagnóstico, Centro Médico de Especialidades Ramón y Cajal, Hospital Universitario Miguel Servet, Zaragoza, Spain
b Centro Universitario de la Defensa, Zaragoza, Spain
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Table 1. Absolute and relative frequencies of explanatory variables based on the diagnosis of needles.
Table 2. Results from the logistic regression analysis for the detection of malignant thyroid nodule.a
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Abstract
Objective

To retrospectively review the diagnostic capacity of semiquantitative elastography in differentiating between benign and malignant thyroid nodules.

Patients and methods

We analyzed 314 thyroid nodules in 295 consecutive patients referred to the endocrinology department for cytological study, studying all by conventional ultrasonography, elastography, and fine-needle aspiration cytology (FNAC). Using a semiquantitative elastography system that portrays tissue stiffness through a color map, we designed our own classification system for thyroid nodules based on their characteristics on elastography. We classified nodules into three groups: predominantly soft, predominantly stiff, and mosaic patterned. We used logistic regression analysis to investigate the relation between elastography and thyroid cancer.

Results

We obtained a definite diagnosis of malignancy after surgery in 19 nodules, of which on elastography 8 had the mosaic pattern, 6 were predominantly stiff, and 5 were predominantly soft. We found no significant association between the pattern on elastography and the probability of malignancy in any of the models.

Conclusion

According to our study, a probability of malignancy in a thyroid nodule is not related to the findings at elastography. Therefore, semiquantitative elastography as used in this study cannot obviate FNAC.

Keywords:
Thyroid nodule
Elastography
Biopsy
Resumen
Objetivo

Evaluar retrospectivamente la capacidad diagnóstica de la elastografía semicuantitativa para diferenciar entre nódulos tiroideos benignos y malignos.

Pacientes y métodos

Se analizaron 314 nódulos tiroideos de 295 pacientes consecutivos remitidos por el Servicio de Endocrinología del Centro Médico de Especialidades para estudio citológico; a todos ellos se les realizó ecografía convencional, elastografía y punción aspirativa con aguja fina. Disponemos de una elastosonografía semicuantitativa que mediante un mapa de colores refleja la elasticidad de los tejidos. Elaboramos una clasificación propia de los nódulos tiroideos basándonos en sus características de elastografía, distinguiendo tres grupos: predominantemente blandos, predominantemente rígidos y en mosaico. Se realizó un análisis estadístico mediante regresión logística para investigar la relación entre la elastografía y el cáncer de tiroides.

Resultados

Obtuvimos un resultado definitivo de malignidad después de la cirugía en 19 nódulos, de los cuales 8 presentaron un patrón en mosaico en la elastografía, 6 fueron predominantemente rígidos y 5 predominantemente blandos. En ninguno de los modelos estimados obtuvimos que el patrón de elastografía analizado estuviera significativamente relacionado con la probabilidad de malignidad del nódulo tiroideo.

Conclusión

La probabilidad de malignidad de un nódulo tiroideo, según nuestro estudio, no está relacionada con los resultados de la elastografía. Por consiguiente, la elastografía semicuantitativa, tal y como nosotros la hemos definido, no permite reducir el número de punciones aspirativas con aguja fina realizadas.

Palabras clave:
Nódulo tiroideo
Elastografía
Biopsia

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