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HEAD AND NECK RADIOLOGY Table of Contents   
Year : 2013  |  Volume : 23  |  Issue : 4  |  Page : 337-341
Qualitative ultrasound elastography assessment of benign thyroid nodules: Patterns and intra-observer acquisition variability

1 Centre d'imagerie Médicale, 47 Boulevard du Pont Rouge, 15000 Aurillac, France
2 Centre de Pathologie, 23 av République, 15000 Aurillac, France
3 Department of Radiation Oncology, Antoine Lacassagne Cancer Research Center, 33 Avenue Valombrose, 06189 NICE cedex 1, France
4 Department Oncology Breast Surgery, Antoine Lacassagne Cancer Research Center, 33 Avenue Valombrose, 06189 NICE cedex 1, France
5 Department of Medical Imaging, François Baclesse Center, 3, Avenue du Général Harris, 14076 Caen cedex 05, France

Correspondence Address:
Alexis Lacout
Centre d'imagerie Médicale, 47, Boulevard du Pont Rouge, 15000 Aurillac
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/0971-3026.125612

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Purpose: To report and evaluate qualitative elastography patterns by using gray-scale and Doppler ultrasound (US) in patients presenting with benign thyroid nodules and to evaluate the reproducibility of US elastography examinations. Materials and Methods: Institutional review board approval was obtained, and all patients provided informed consent. Over a 3-month time period, all consecutive adult patients were referred to our institution to undergo a thyroid nodule fine-needle aspiration biopsy (FNAB) procedure. Patients presenting with benign cytology according to the Bethesda 2008 classification were prospectively enrolled in the study. Each thyroid nodule was assessed by using gray-scale, Doppler US, and elastography acquisitions by a single operator (A. L.). Multiple elastography acquisitions per thyroid nodule were performed and elastography scorings of the nodules were compared with each other. Results: Nineteen patients (16 women and 3 men, mean age 58 years) with 22 thyroid nodules were included in the present study. Elastographic patterns 1, 2, and 3 were reported (23% nodules showed pattern 3). The elastography pattern showed a strong variability in 13 nodules (59%). The elastography acquisition result variability involved the "malignant" pattern 3 in 36% of cases. Conclusion: Almost one-third of benign thyroid nodules displayed pattern 3 on qualitative US elastography. The intra-observer variability of the benign thyroid elastography scoring is wide, thus limiting the thyroid nodule US examination accuracy. In FNAB-proven benign thyroid nodules, elastography pattern 3 is frequent and cannot be used as a strong indicator of thyroid malignancy.

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