%0 Journal Article
%T Q-Elastography in the Presurgical Diagnosis of Thyroid Nodules with Indeterminate Cytology
%A Vito Cantisani
%A Salvatore Ulisse
%A Eleonora Guaitoli
%A Corrado De Vito
%A Riccardo Caruso
%A Renzo Mocini
%A Vito D¡¯Andrea
%A Valeria Ascoli
%A Alfredo Antonaci
%A Carlo Catalano
%A Francesco Nardi
%A Adriano Redler
%A Paolo Ricci
%A Enrico De Antoni
%A Salvatore Sorrenti
%J PLOS ONE
%D 2012
%I Public Library of Science (PLoS)
%R 10.1371/journal.pone.0050725
%X Quantitative ultrasound (US) elastography (Q-USE), able to evaluate tissue stiffness has been indicated as a new diagnostic tool to differentiate benign from malignant thyroid lesions. Aim of this prospective study, conducted at the Department of Surgical Sciences, of the ¡°Sapienza¡± University of Rome, was to evaluate the diagnostic accuracy of Q-USE, compared with US parameters, in thyroid nodules with indeterminate cytology (Thy3).The case study included 140 nodules from 140 consecutive patients. Patient¡¯s thyroid nodules were evaluated by Q-USE, measuring the strain ratio (SR) of stiffness between nodular and surrounding normal thyroid tissue, and conventional US parameters prior fine-needle aspiration cytology. Those with Thy3 diagnosis were included in the study. Forty of the nodules analyzed harbored a malignant lesion. Q-USE demonstrated that malignant nodules have a significant higher stiffness with respect to benign one and an optimun SR cut-off value of 2.05 was individuated following ROC analysis. Univariate analysis showed that hypoechogenicity, irregular margins and SR >2.05 associated with malignancy, with an accuracy of 67.2%, 81,0% and 89.8%, respectively. Data were unaffected by nodule size or thyroiditis. These findings were confirmed in multivariate analysis demonstrating a significant association of the SR and the irregular margins with thyroid nodule¡¯s malignancy. In conclusion, we demonstrated the diagnostic utility of Q-USE in the differential diagnosis of thyroid nodules with indeterminate cytology that, if confirmed, could be of major clinical utility in patients¡¯ presurgical selection.
%U http://www.plosone.org/article/info%3Adoi%2F10.1371%2Fjournal.pone.0050725