Munnaza Nazir, Muhammad Imran, Tariq Mahmud Mirza, Asma Tariq.
Role of Elastography in Differentiating Malignant and Benign Thyroid Nodules Using FNAC as a Reference Standard.
Pak J Radiol Jan ;27(3):200-6.

BACKGROUND: Ultrasound elastography is a noninvasive technique for evaluating thyroid nodules that encompasses a variety of approaches such as supersonic shear imaging and acoustic radiation force impulse imaging as well as real-time tissue elastography. This technique is very useful in differentiating malignant thyroid nodules from benign ones. OBJECTIVE: To determine the diagnostic accuracy of ultrasound elastography in differentiating benign from malignant thyroid nodules by using FNAC as a reference standard METHODOLOGY: 165 patients were selected for this study. The ultrasound examination including grey scale, doppler as well as elastography of thyroid nodules. Then ultrasound guided FNAC of selected nodule was performed and its result was obtained in order to compare diagnosis of ultrasound elastography and cytolology as operational definition. RESULTS: In our study, 42.42%(n=70) were males and 57.58%(n=95) were females,61.82%(n=102) were between 18-40 years of age while 38.18%(n=63) were between 41-60 years of age, Mean +SD was calculated as 35.81+9.03 years, frequency of malignant thyroid nodules on reference standard was recorded as 6.67%(n=11) while 93.33%(n=154) were benign, FNAC as reference standard shows that 81.82%, 95.45%, 56.25%, 98.65% and 98.09% had sensitivity, specificity, positive predictive value, negative predictive value, and accuracy rate. CONCLUSION: Elastography has great potential as an adjunctive tool with other ultrasound modalities in diagnosing benign and malignant thyroid lesions. It is easy and rapid to perform and reduces the burden of unnecessary invasive procedures.

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