He Ya-Ping, Xu Hui-Xiong, Wang Dan, Li Xiao-Long, Ren Wei-Wei, Zhao Chong-Ke, Bo Xiao-Wan, Liu Bo-Ji, Yue Wen-Wen
Department of Medical Ultrasound, Shanghai Tenth People's Hospital, Ultrasound Research and Education Institute, Tongji University School of Medicine, Shanghai, China.
Thyroid Institute, Tongji University School of Medicine, Shanghai, China.
Clin Hemorheol Microcirc. 2017;65(4):349-361. doi: 10.3233/CH-16197.
The purpose of this study was to comparatively evaluate the two different shear wave speed (SWS) imaging systems of Toshiba shear wave elastography (T-SWE) and SuperSonic SWE (S-SWE) in distinguishing malignant from benign thyroid nodules (TNs).
140 patients with 140 focal TNs were enrolled and underwent T-SWE and S-SWE before fine-needle aspiration (FNA) biopsy or surgery. SWE indices of mean, standard deviation and maximum values (E-mean, E-SD and E-max) of elastic modulus in TNs were measured on a color-coded mapping. The receiver operating characteristic (ROC) curve was performed to assess the diagnostic performance.
Of the 140 nodules, 47 were thyroid carcinomas and 93 were benign. Areas under the receiver operating characteristic curve (AUC) were the highest with E-max among the three SWE parameters both for T-SWE and S-SWE (0.816 and 0.799). The most accurate cut-off values, sensitivity, specificity, accuracy, positive predictive value (PPV) and negative predictive value (NPV) were 26.6 kPa versus 42.9 kPa, 83.0% versus 63.8%, 68.8% versus 88.2%, 72.9% versus 80.0%, 56.5% versus 73.2% and 88.7% versus 82.8% with E-max for T-SWE and S-SWE, respectively. Among these comparisons, the sensitivity in T-SWE was statistically higher than S-SWE (83.0% versus 63.8%, p = 0.022), whereas specificity was statistically lower than S-SWE (68.8% versus 88.2%, p < 0.001).
T-SWE is equal to S-SWE with comparable and promising results for diagnosis of TNs. In clinical using, the selection of E-max should be recommended both for T-SWE and S-SWE.
本研究旨在比较评估东芝剪切波弹性成像（T-SWE）和超音波剪切波弹性成像（S-SWE）这两种不同的剪切波速度（SWS）成像系统在鉴别甲状腺结节（TN）良恶性方面的表现。
纳入140例患有140个局灶性TN的患者，在细针穿刺（FNA）活检或手术前接受T-SWE和S-SWE检查。在彩色编码图上测量TN中弹性模量的平均值、标准差和最大值（E-mean、E-SD和E-max）等剪切波弹性成像（SWE）指标。绘制受试者操作特征（ROC）曲线以评估诊断性能。
140个结节中，47个为甲状腺癌，93个为良性。对于T-SWE和S-SWE，在三个SWE参数中，E-max的受试者操作特征曲线下面积（AUC）最高（分别为0.816和0.799）。T-SWE和S-SWE的E-max最准确的截断值、敏感性、特异性、准确性、阳性预测值（PPV）和阴性预测值（NPV）分别为26.6 kPa对42.9 kPa、83.0%对63.8%、68.8%对88.2%、72.9%对80.0%、56.5%对73.2%和88.7%对82.8%。在这些比较中，T-SWE的敏感性在统计学上高于S-SWE（83.0%对63.8%，p = 0.022），而特异性在统计学上低于S-SWE（68.8%对88.2%，p < 0.001）。
T-SWE在诊断TN方面与S-SWE相当，结果具有可比性且前景良好。在临床应用中，对于T-SWE和S-SWE均建议选择E-max。
