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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. 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. 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). The 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. Advances in Cancer Research & Treatment 2

Conventional, Doppler Ultrasound and Real Time Elastography in Diagnostic of Thyroid Solitary Nodules