, Volume 15, Issue 2, pp 197–204 | Cite as

Comparison of color-Doppler and qualitative and quantitative strain-elastography for differentiation of thyroid nodules in daily practice

  • Manuela GötzbergerEmail author
  • Susanne Krueger
  • Roland Gärtner
  • Martin Reincke
  • Matthias Pichler
  • Gerald Assmann
  • Thomas Mussack
  • Michael Zimmermann
  • Veit Gülberg
Research paper


OBJECTIVE: Strain-elastography provides a new ultrasound-based method that can offer information about the stiffness of thyroid nodules as an indicator of malignancy. The aim of our study was to compare the utility of color-Doppler and strain-elastography in differentiating between benign and malignant nodules. DESIGN AND METHODS: 77 thyroid nodules (70 benign and 7 malignant) from 70 unselected patients (48 female/22 male, mean age 49.7±14.3 years) were evaluated with color-Doppler and elastography based on a five-scale elastogram score for qualitative elastography and strain ratio for quantitative elastography. As reference tissue we chose normal thyroid tissue [strain ratio a (SR a)] and cervical muscles [strain ratio b (SR b)]. The cytological or histological results were used as a reference standard. Diagnostic performances of qualitative and quantitative elastography were compared using ROC curves. RESULTS: Vascularization score 3 or 4 was associated with malignancy (p=0.024) as well as elastogram score 4 or 5 (p=0.070, n.s.s.). SR a was indicatively higher and SR b lower in the group of malignant nodules (p=0.065 and p=0.246, n.s.s.). The best cut-off points predicting malignancy were 3.32 for SR a (66.7% sensitivity, 83.3% specificity) and 0.10 for SR b (71.4% sensitivity, 67.1% specificity). CONCLUSION: In our study, the accuracy of elastography did not surpass other sonographic parameters in differentiating thyroid nodules. The technique can play a role as a supplementary parameter in assessment of malignancy to improve diagnostic efficacy. The best parameter is SR a, but SR b can serve as an alternative if SR a is not assessable.

Key words

Elasticity score Strain ratio Thyroid cancer Ultrasound 


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Copyright information

© Hellenic Endocrine Society 2016

Authors and Affiliations

  • Manuela Götzberger
    • 1
    Email author
  • Susanne Krueger
    • 2
  • Roland Gärtner
    • 1
  • Martin Reincke
    • 1
  • Matthias Pichler
    • 1
  • Gerald Assmann
    • 3
  • Thomas Mussack
    • 4
  • Michael Zimmermann
    • 5
  • Veit Gülberg
    • 1
  1. 1.Medizinische Klinik und Poliklinik IVKlinikum der Universität MünchenMunchenGermany
  2. 2.Klinikum BogenhausenKlinikum der Universität MünchenMunchenGermany
  3. 3.Pathologisches InstitutKlinikum der Universität MünchenMunchenGermany
  4. 4.Klinik für Viszeral- und Endokrine Chirurgie - Campus InnenstadtKlinikum der Universität MünchenMunchenGermany
  5. 5.Maria-Theresia-KlinikMunichGermany

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