Background: In the presence of a solid thyroid nodule, the therapeutically approach is imposed
by the probability of a malignancy. Ultrasound is considered to be “the” imagistic
diagnostic tool, and the golden standard is represented by the FNAB. US elastography
is currently used in differentiation of malignant from benign lesions.
Method: This prospective study included 112 patients, mean age 52.08 ± 11.43 years, 65 females
and 47 men, with solitary thyroid nodules on conventional US, with a volume higher
than 0.50 ml. Complete ultrasound evaluation was performed for each case: gray scale,
Doppler and strain elastography. All patients underwent surgery after complete evaluation.
Extemporaneous and postsurgical histopathological exam were performed in all cases.
Results: We identified 19 cases with cancer and 93 benign lesions. We calculated the diagnostic
value for each ultrasound parameter, and we saw that some parameters are significant
in diagnosing thyroid malignancy: irregular margins (AUC = 0.761, p = 0.00001), taller
than wide (AUC = 0.723, p = 0.0001), positive calcification (AUC = 0.7416, p = 0.0001),
absent halo sign (AUC = 0.717, p = 0.0001), extracapsular invasion (AUC = 0.684, p
= 0.0012). Presence of 4 suspect signs increases diagnostic quality (AUC = 0.8529,
p = 0.000), and combined evaluation US-2B and Doppler have even better results (AUC
= 0.8985, p = 0.00001.
Nevertheless, diagnostic quality of RTE is higher than all separate or combine conventional
ultrasound evaluation: AUC = 0.99, p = 0.0001
Conclusion: RTE color map screen is a useful tool in discriminating solitary thyroid masses.
