The SWE Combined With Conventional Ultrasound Multi-parameter Weight Method To Distinguish Benign And Malignant Thyroid Nodules

Objective:Based on the characteristics of conventional ultrasound and shear wave elastography(SWE)of thyroid nodule,the multi-parameter weight prediction model was constructed,and the value of the new model of SWE combined with conventional ultrasound multi-parameter weight method in the differential diagnosis of benign and malignant thyroid nodule was discussed.Methods:A total of 175 thyroid nodules were collected from 168 patients who underwent surgery or ultrasound-guided fine needle aspiration cytology(US-FNAC)in Shanxi People’s Hospital from June 2021 to September 2022 with definitive pathological findings and complete routine ultrasound and SWE data.145 nodules of 138 consecutive patients were included in the modeling cohort.Thirty nodules from 30 consecutive patients were included in the validation cohort.Single factor analysis was used to determine the risk factors of conventional ultrasonic characteristics and SWE parameters.Binary logistic regression analysis was used to screen independent risk factors,and the odds ratio(OR)of each risk factor was calculated.According to the OR values of relevant indicators,the total score of each nodule was calculated,the receiver operating characteristic curve(ROC)was drawn,the prediction model based on the weight of multiple parameters was established,and the area under the curve(AUC)was calculated to evaluate the diagnostic performance of the model,and the verification was performed in the validation queue.Results:In SWE parameters,ROC showed that the AUC of maximum elastic modulus(0.813)was higher than the average elastic modulus(0.730),and the optimal critical point was38.3k Pa,which was the best parameter to distinguish thyroid benign and malignant nodules(P < 0.001).In conventional ultrasound parameters,aspect ratio ≥ 1,solid component and echogenic foci were independent risk factors.According to the OR values of different parameters,the prediction model based on the weight of multiple parameters was obtained.The AUC of the model was 0.906,the 95% confidence interval was0.850-0.961,the sensitivity was 87.4%,the specificity was 90.5%,the PPV was 95.7%,the NPV was 74.5%,and the accuracy was 88.0%.The AUC for the differentiation of benign and malignant thyroid nodules in the validation cohort was 0.918,95%confidence interval 0.808-0.985,sensitivity 91.9%,specificity 75.0%,PPV 91.9%,NPV75.0%,accuracy 87.0%.Conclusion:The new model of SWE combined with conventional ultrasound multi-parameter weighting method is helpful to improve the application value of ultrasonic multimodal imaging technology in benign and malignant thyroid nodules,and provide a simple and economical selection strategy for clinical practice including US-FNAC.