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Combined Value of Virtual Touch Tissue Quantification and Conventional Sonographic Features for Differentiating Benign and Malignant Thyroid Nodules Smaller Than 10 mm
Author(s) -
Zhang Huiping,
Shi Qiusheng,
Gu Jiying,
Jiang Luying,
Bai Min,
Liu Long,
Wu Ying,
Du Lianfang
Publication year - 2014
Publication title -
journal of ultrasound in medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.574
H-Index - 91
eISSN - 1550-9613
pISSN - 0278-4297
DOI - 10.7863/ultra.33.2.257
Subject(s) - medicine , thyroid nodules , echogenicity , malignancy , radiology , predictive value , nodule (geology) , cutoff , differential diagnosis , ultrasonography , thyroid , nuclear medicine , pathology , paleontology , physics , quantum mechanics , biology
Objectives This study aimed to investigate the value of sonographic features including Virtual Touch tissue quantification (VTQ; Siemens Medical Solutions, Mountain View, CA) for differentiating benign and malignant thyroid nodules smaller than 10 mm. Methods Seventy‐one thyroid nodules smaller than 10 mm with pathologic diagnoses were included in this study. The conventional sonographic features and quantitative elasticity features (VTQ) were observed and compared between benign and malignant nodules. Results There were 39 benign and 32 malignant nodules according to histopathologic examination. When compared with benign nodules, malignant nodules were more frequently taller than wide, poorly defined, and markedly hypoechoic ( P < .05). Color Doppler sonographic features were not significantly different between benign and malignant nodules. The VTQ value for malignant nodules (mean ± SD 3.260 ± 0.725 m/s) was significantly higher than that of benign ones (2.108 ± 0.455 m/s; P < .001). The cutoff point for the differential diagnosis was 2.910 m/s, with sensitivity, specificity, a positive predictive value, a negative predictive value, and diagnostic accuracy of 71.9%, 100%, 100%, 81.2%, and 87.3% respectively. Logistic regression analysis showed that a taller‐than‐wide shape, a poorly defined boundary, marked hypoechogenicity, and a VTQ value greater than 2.910 m/s were independent risk factors for malignancy, with odds ratios of 69.366, 41.864, 5.945, and 64.991. The combination of VTQ with a taller‐than‐wide shape had the highest sensitivity and specificity of 90.6% and 97.4%. Conclusions The shape, margin, echogenicity, and VTQ value are useful sonographic criteria for differentiating benign and malignant thyroid nodules smaller than 10 mm. When VTQ was combined with B‐mode sonographic features, the sensitivity was improved significantly.