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Shear Wave Elastography Combining with Conventional Grey Scale Ultrasound Improves the Diagnostic Accuracy in Differentiating Benign and Malignant Thyroid Nodules

Department of Health Technology and Informatics, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong, China
Department of Surgery, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong, China
Authors to whom correspondence should be addressed.
Appl. Sci. 2017, 7(11), 1103;
Received: 11 September 2017 / Revised: 30 September 2017 / Accepted: 13 October 2017 / Published: 25 October 2017
(This article belongs to the Special Issue Ultrasound Elastography)
PDF [1845 KB, uploaded 25 October 2017]


Shear wave elastography provides information about the stiffness of thyroid nodules that could be a new indicator of malignancy. The current study aimed to investigate the feasibility of using shear wave elastography (SWE) alone and in conjunction with grey scale ultrasound (GSU) to predict malignancy in 111 solitary thyroid nodules. Malignant thyroid nodules tended to have microcalcification, hypoechogenicity, tall to width ratio >1, and irregular borders (p < 0.05). SWE indices (Emaximum and Emean) of malignant nodules (median ± standard error: 85.2 ± 8.1 kPa and 26.6 ± 2.5 kPa) were significantly higher than those of benign nodules (median ± standard error: 50.3 ± 3.1 kPa and 20.2 ± 1 kPa) (p < 0.05). The optimal cut-off of Emaximum and Emean for distinguishing benign and malignant nodules was 67.3 kPa and 23.1 kPa, respectively. Diagnostic performances for GSU + Emaximum, GSU + Emean, GSU, Emaximum and Emean were: 70.4%, 74.1%, 96.3%, 70.4% and 74.1% for sensitivity, 83.3%, 79.8%, 46.4%, 70.2%, and 66.7% for specificity, and 80.2%, 78.4%, 58.5%, 70.3%, and 68.5% for accuracy, respectively. Our results suggested that combining GSU with SWE (using Emaximum or Emean) increased the overall diagnostic accuracy in distinguishing benign and malignant thyroid nodules. View Full-Text
Keywords: ultrasound; thyroid cancer; shear wave elastography ultrasound; thyroid cancer; shear wave elastography

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Baig, F.N.; Liu, S.Y.W.; Lam, H.-C.; Yip, S.-P.; Law, H.K.W.; Ying, M. Shear Wave Elastography Combining with Conventional Grey Scale Ultrasound Improves the Diagnostic Accuracy in Differentiating Benign and Malignant Thyroid Nodules. Appl. Sci. 2017, 7, 1103.

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