Purpose
AIM:
The aim of the study is todetect the impact of ARFI elastography on TIRADS categorization in risk stratification of thyroid nodules.
To differentiate benign and malignant thyroid nodules by ARFI (VTQ and VTI images).
To determine the impact of ARFI on TIRADS classification with cytology as gold standard.
BACK GROUND:
Only 5% of the incidentally detected thyroid nodules are malignant(1).
Based on ultrasound finding thyroid nodules can be grouped under 6 categories according to TIRADS(2)( Fig. 1 ).
FNAC or biopsy is warrented for...
Methods and materials
Inclusion criteria:
Patients with thyroid swelling or palpable thyroid nodule.
Patients who were found to have thyroid nodules incidentally during CT scan of neck or chest for some other purpose.
Exclusion Criteria:
Maximum nodule diameter < 5 mm.
Completely anechoic lesion (cyst) with no solid component,
which did not require fine needle aspiration cytology.
Inconclusive cytology due to inadequate sample or hemorrhagic material.
Sample size:
86 patients with 141 nodules were studied,
out of them 79 patients with 130 nodules were included in the study....
Results
CYTOLOGY:
Out of the 130 nodules 117(90%) were proved by cytology to be benign and 13(10%) were malignant.
TheCytological distribution of nodules is shown in figure 5( Fig. 4 ) .
ULTRASOUND:
Based on conventional ultrasound findings all the 130 nodules were categorize as per TIRADS criteria ( Fig. 5 ).
For statistical analysis,
nodules under category 2 and category 3 were considered as benign and the nodules under category 4 and category 5 were considered as malignant.
VTQ ANALYSIS:
The mean VTQ value (shear...
Conclusion
IMPACT OF VTQ AND VTI ON TIRADS:
28 nodules were grouped under TIRADS category 4 and 5 as per ultrasound findings.
Out of these 28 nodules,
9 nodules (33 %) were found to be malignant on cytology.( Fig. 9 )
All 4 cytologically malignant nodules in TIRADS 5 were correctly categorized as malignant by ARFI also.
When VTQ values of these nodules were analysed only 14 out of the 28 nodules were identified as malignant .
3 out of 7 nodules in TIRADS category 4A...
Personal information
Dr.Bagyam Raghavan,
Senior Consultant,
Department Of Radiology,
Apollo Speciality Hospital,
Chennai.
Email:
[email protected]
Dr.
Dayala Sundaram
Final Year DNB Senior Resident
Department Of Radiology,
Apollo Speciality Hospital,
Chennai.
Email:
[email protected]
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