Erman ÇAKAL, Mustafa ŞAHİN, Melia KARAKÖSE, Mustafa ÖZBEK, BEKİR UÇAN, İlknur Öztürk ÜNSAL

The diagnostic value of elastography score and strain index for the evaluation of thyroid micronodules

Background/aim: In the general population, the frequency of thyroid micronodules is increasing, and the prevalence of malignancyis higher for such nodules. Ultrasonography findings of these nodules are neither specific nor sensitive. The aim of this study was toinvestigate the diagnostic value of elastography in patients with thyroid micronodules.Materials and methods: A total of 224 patients with thyroid micronodules were recruited in this prospective study. All patientsunderwent a thyroid fine-needle aspiration biopsy. Elastography scores (ESs) and strain indexes (SIs) were measured with real-timeultrasound elastography.Results: Malignant micronodules had higher ES and SI values than those of benign micronodules (P < 0.001). When ES was used todiagnose malignancy, scores of >3 showed sensitivity of 79.4% and specificity of 98.1%. The area under the curve (AUC) for ES was0.888 (P < 0.001). The optimal SI cutoff value that differentiated benign from malignant micronodules was 3.06 (98% sensitivity; 91%specificity). The AUC for SI was 0.970 (P < 0.001).Conclusions: ES and SI are beneficial markers for detecting malignant thyroid micronodules. We showed that SI is better than ES whenassessing the malignancy of thyroid micronodules.

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