Diagnostic Accuracy of Strain Elastography in Thyroid Nodule Assessment Using Histopathology as Reference Standard

Background: Ultrasound elastography functions on the property of soft tissues that deform readily than harder ones under compression. This technique is beneficial in differentiating malignant and benign lesions in different organs i.e. breast, lymph nodes, prostate and pancreas. Recent years have seen significant research in differential diagnosis using this method.Objectives: The study aims to find diagnostic accuracy of ultrasound elastography (USE) in thyroid nodule assessment using histopathology results as reference standard.Methods: This study employed a prospective observational design to find diagnostic accuracy of USE in identification of thyroid nodules to be benign or malignant. A comprehensive review of existing literature on USE and thyroid nodule characterization was conducted. The study included 175 patients aged between 18 and 80 years, presenting with one or more solid nodules in the thyroid lobe. Patients aged 18-80 years with solid nodules in the thyroid lobe identified by conventional ultrasound were included. Ultrasound elastography was performed, and strain ratios were calculated from the strain elastography color-coded images. These strain ratios were compared with histopathology reports to determine diagnostic accuracy and find correlation between ultrasound elastography findings and histopathology results. Institutional Review Board approval was obtained to ensure adherence to ethical guidelines and hence, written agreement was made with all participants of study.Results: The results obtained through this comparative study of using strain elastography and histopathology to differentiate benign and malignant thyroid nodules were very convincing and consistent to previous studies. Statistical analysis results came out to be as sensitivity 94.38%, specificity 90.70%, PPV 91.30%, NPV 93.98% and diagnostic accuracy 92.57%.Conclusion: The research findings indicate that strain ultrasound elastography is key imaging technique in detection of malignant thyroid nodules. Non-invasiveness and high diagnostic accuracy compels to use the method for identifying malignant thyroid nodules.