Role of Ultrasound Elastrography in Various Thyroid Nodules with Cytological / Histopathological Correlation

Introduction: Elastography is a newly developed dynamic technique that uses ultrasound to provide an estimation of tissue stiffness by measuring the degree of distortion under the application of an external force. Ultrasound elastography has been applied to differentiate malignant from benign lesions. Materials and Methods: This study included 53 consecutive patients with thyroid nodules. High resolution ultrasound elastography examination, scoring and further fine needle aspiration cytology was done in all of the cases. Tissue stiffness on ultrasound elastography was scored from on (greatest elastic strain) to five (no strain). Results: Fifty three cases were evaluated by real time ultrasound elastography. Seventeen (33%), 22 (39%), 6 (12%), 6 (12%), 2 (4%) were assigned score of 1,2,3,4 and 5 respectively. The elasticity scores 4-5 were highly predictive of malignancy with a sensitivity of 87.5%, a specificity of 97.6%, a positive predictive value of 87.5%, and a negative predictive value of 97.6%. Conclusion: Ultrasound elastography has great potential as an adjunctive tool for the diagnosis of thyroid cancer. Larger prospective studies are needed to confirm these results and establish the diagnostic accuracy of this new technique