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Objective: We aimed to investigate the contribution of strain elastosonography to the distinction of benign and malignant thyroid nodules. Materials and Methods: The retrospective study included 135 patients who were detected with thyroid nodules on ultrasonography and then underwent fineneedle aspiration biopsy (FNAB). Semi-quantitative strain elastographic evaluation was performed and mean strain ratio was calculated for each nodule. The elastograms were classified using the Tsukuba fivepattern visual scoring system. Accordingly, the lesions with scores 1 and 2 were accepted as soft nodules (benign), score 3 as moderately hard nodules, and scores 4 and 5 as hard nodules (malignant). The nodules were divided as benign and malignant depending on the histopathological results. The FNAB results were compared with elasticity scores. Results: The patients included 18 (13.3%) men and 117 (86.7%) women. Of the 135 lesions, 113 (83.7%) were benign and 22 (16.3%) were malignant. Strain ratio value was statistically higher in malignant lesions compared to benign lesions (p<0.01). When compared with the histopathological results, elastosonography scoring had a sensitivity of 81.8%, specificity of 89.4%, positive predictive value (PPV) of 96.2%, and negative predictive value (NPV) of 64.7%. However, compared with the strain ratio values, elastosonography scoring had a sensitivity of 77.3%, specificity of 87.6%, PPV of 95.2%, and NPV of 54.8% at a cutoff point of 4.850. Conclusion: Elastosonography is highly effective in the differentiation of benign and malignant lesions.

Contribution of Ultrasound Strain Elastography to the Differentiation of Benign and Malignant Thyroid Lesions: Randomized Controlled Study