A prospective study; diagnostic role of shear-wave elastography to differentiate benign and non-benign thyroid nodules categorized to according to the ACR2017 TI-RADS

Abstract

Objective: The differentiation between benign and non-benign thyroid nodules is a complex problem to solve in clinical practice. We aimed to observe and describe the role of shear-wave elastography (SWE) to distinct benign and non-benign thyroid nodules before a fine-needle aspiration biopsy (FNAB).Methods: Ninety-seven patients were prospectively included in the study from March 2019 to January 2020. Patients with a history of thyroid infections, surgery or trauma of thyroid tissue, autoimmune diseases associated with thyroid gland, non-diagnostic histopathology (Bethesda I) were excluded from the study. Thyroid imaging reporting and data system (TI-RADS) based on the 2017 American College of Radiology (ACR) was used for the radiological classification of nodules. Patients' age, number of thyroid nodules, SWE value of nodules, and TI-RADS categories were compared to pathological classification.Results: The mean age of patients was 49.80 & PLUSMN;11.42 years. Benign thyroid nodules were classified as "Group 1" (G1) (n=79) and non-benign thyroid nodules as "Group 2" (G2) (n=12) according to pathological diagnosis. The median SWE values of patients in G1 and G2 were 9.47 (7.48) and 47.38 (51.46) kPa, respectively. The median SWE values of G2 were statistically significantly higher than G1 (p=0.001). While nearly 50% of the patients in the G1 were in TI-RADS category 3, the ratio of TI-RADS 5 was over 40% in the G2 and the difference was statistically significant in terms of the TI-RADS category (p=0.001)Conclusion: In addition to TI-RADS classification based on 2017 ACR, SWE measurements of thyroid nodules may differentiate benign and non-benign thyroid nodules before an FNAB. For this reason, both methods can be combined to increase the diagnosis's specificity, sensitivity, and accuracy.