Eur J Radiol. 2012 Dec;81(12):3965-72. doi: 10.1016/j.ejrad.2012.09.002. Epub 2012 Sep 30.

A threshold value in Shear Wave elastography to rule out malignant thyroid nodules: a reality?

Veyrieres JB, Albarel F, Lombard JV, Berbis J, Sebag F, Oliver C, Petit P.

Source

Département d'imagerie médicale, Hôpital d'Instruction des Armées St Anne, Bd Saint Anne, BP 20545 Toulon cedex, France. jbveyrieres@hotmail.fr

Abstract

OBJECTIVES:

To evaluate the ability of a threshold value in ShearWave™ elastography to rule out malignant thyroid nodules while studying its pertinence in association with morphological signs. EQUIPMENT AND METHODS: 148 patients (110 women and 38 men; 52.5 y.o. 15.8) referred for surgery of thyroid nodules underwent standard ultrasound as well as elastography. Characteristics of the morphological signs and maximum elastographic index were calculated in relation to histology. Association of morphological signs alone and then of elastography was also evaluated. One hundred and fifty one nodules were studied on a double-blind basis.

RESULTS:

297 nodules were studied. Thirty-five cancers were detected (11.6%). Elastographic index was higher in malignant nodules (115 kPa 60.4) than in benign nodules (41 kPa 25.8) (p<0.001, Student's t-test). Cut off value of 66 kPa was the best to discriminate malignant nodules with a sensitivity of 80% (CI 95%, 62.5; 90.9) and a specificity of 90.5% (CI 95%, 86.1; 93.6) (p=0.0001). Association of elastography and morphological ultrasound signs presented a sensitivity of 97% (CI 95%, 83.3; 99.8) and a negative predictive value of 99.5% (CI 95%, 95.6; 99.9). Interobserver reproducibility proved to be excellent with an interclass correlation of 0.97 (CI 95%, 0.96; 0.98) (p<0.001).

CONCLUSION:

The 66 kPa threshold in Shear Wave elastography is the best ultrasound sign to rule out malignant thyroid nodules. The method is simple, quantitative, reproducible and usable in the study of nodules larger than 3 cm. Progress must still be made in the study of calcified nodules and follicular tumors.

Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

Source : http://www.ncbi.nlm.nih.gov/pubmed/23031543

New guidance emerges on ultrasound for liver fibrosis

New guidance emerges on ultrasound for liver fibrosis

By AuntMinnieEurope.com staff writers

January 22, 2013 -- The Technology Assessment Centre (NTAC) of the U.K. National Health Service (NHS) has published a guide recommending that ultrasound elastography be performed instead of a biopsy for the diagnosis of liver fibrosis in a patient.

NTAC studied the implementation of ultrasound elastography within secondary care at three NHS trusts, or hospital groups. These included the King's College Hospital NHS Foundation Trust in London, the North West London Hospitals NHS Trust, and the East Cheshire NHS Trust.

The York Health Economic Consortium performed economic modeling based upon real life implementation costs. York estimated a gross savings of 520 pounds (618 euros) per diagnosis. When extrapolated across the NHS, this equates to an estimated savings of 14.3 million pounds (16.99 million euros) per annum.