DIAGNOSTIC PERFORMANCE OF ULTRASOUND STRAIN ELASTOGRAPHY IN TRANSVERSE AND LONGITUDINAL VIEWS IN PREDICTING MALIGNANT THYROID NODULES

Agreement between ultrasound strain elastography (SE) scores of transverse and longitudinal views of thyroid nodules was investigated, and the diagnostic performance of these scores in predicting thyroid malignancy was assessed. From December 2016 to February 2017, a total of 250 thyroid nodules in 232 patients (62 males and 188 females, mean age: 45 y [20-75 y]) were enrolled. Diagnostic agreement between SE scores obtained in different views was assessed. Sensitivity, specificity, area under the receiver operating characteristic curve (Az) of the SE score in different criteria (criterion 1, SE score >= 4 from any view is defined as suspicious; criterion 2, SE score >= 4 as in only transverse view; and criterion 3, SE score >= 4 only from longitudinal view) were evaluated. Diagnostic agreement between SE scores of different views was fair (kappa = 0.227). The Az value for criterion 1 (0.770, 95% confidence interval [CI]: 0.713, 0.820) was the highest among the three criteria, significantly higher than that of criterion 2 (0.692, 95% CI: 0.631, 0.749) (p < 0.001), but not statistically significantly different from that of criterion 3 (0.768, 95% CI: 0.711, 0.819) (p = 0.909). However, the Az value for criterion 3 was higher than that for criterion 2 (p < 0.005). The results indicated that criterion 1 had high sensitivity (80.0%) and criterion 2 had high specificity (68.0%). Our study found that the agreement between SE scores of different views was fair. SE scores >= 4 in either view were most sensitive for predicting malignant thyroid nodules. (C) 2019 The Author(s). Published by Elsevier Inc. on behalf of World Federation for Ultrasound in Medicine & Biology.