Quality measurement on shear wave speed imaging: diagnostic value in differentiation of thyroid malignancy and the associated factors
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Bo-Ji Liu1,2,*, Chong-Ke Zhao1,2,*, Hui-Xiong Xu1,2, Yi-Feng Zhang1,2, Jun-Mei Xu1,2, Dan-Dan Li1,2, Xiao-Wan Bo1,2, Xiao-Long Li1,2
1Department of Medical Ultrasound, Shanghai Tenth People’s Hospital, Ultrasound Research and Education Institute, Tongji University School of Medicine, Shanghai 200072, China
2Thyroid Institute, Tongji University School of Medicine, Shanghai Center for Thyroid Diseases, Shanghai 200072, China
*These authors contributed equally to this work
Hui-Xiong Xu, email: firstname.lastname@example.org
Keywords: shear wave elastography, shear wave speed imaging, thyroid nodule, quality measurement
Received: September 26, 2016 Accepted: December 01, 2016 Published: December 16, 2016
To evaluate the associated factors for quality measurement (QM) on shear wave speed (SWS) imaging and the additional value of QM for differentiation of thyroid nodules. A consecutive series of 238 patients with 254 thyroid nodules were enrolled. They were all evaluated by conventional ultrasound and SWS imaging and were finally proven pathologically. QM was used to assess whether SWS propagation was authentic and was classified as high QM and Low QM. Twelve variables were analyzed to evaluate the associated factors for QM using binary logistic regression. Receiver operating characteristic (ROC) curve was plotted on SWS and SWS+QM. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), accuracy and area under ROC curve (AUC) were calculated. The study included 170 benign thyroid nodules (160 high QM and 10 low QM) and 84 malignant thyroid nodules (56 high QM and 28 low QM) (P < 0.001). The mean SWS of benign and malignant nodules were 2.51 ± 0.47 m/s and 3.43 ± 1.21 m/s respectively (P < 0.001). The sensitivities, specificities, PPVs, NPVs, accuracies and AUCs were 77.4%, 80.0%, 65.7%, 87.7%, 79.1%, 0.82 for SWS alone with SWS ≥ 2.78 m/s; 33.3–34.5%, 91.2–94.1%, 65.9–73.7%, 73.8–74.1%, 72.4–74.0%, 0.63–0.64 for QM alone and 84.5–85.7%, 72.4–75.9%, 60.5–63.4%, 90.8–91.0%, 76.8–78.7%, 0.79–0.80 for SWS+QM. Nodule depth was identified to be the strongest associated factor for QM of SWS, followed by malignancy and SWS. In conclusion, QM for thyroid nodule is associated with nodule depth, malignancy, and SWS. QM improves the specificity in comparison with SWS alone, whereas SWS+QM does not improve the overall diagnostic performance.
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