The Value Of Virtual Touch Tissue Quantification Technology For Differentiating Between Benign And Malignant Thyroid Nodules

Objective: The study aimed to evaluate the differential diagnosis feasibility of acoustic radiation force impulse elasticity imaging for differentiating between benign and malignant thyroid lesions.Methods: 78 hospitalized patients with 92 thyroid nodules undergoing thyroid nodules surgery were evaluated.After routine high-resolution ultrasound,the patients underwent ARFI(acoustic radiation force impulse,ARFI)elasticity imaging examination.ARFI image include VTI(virtual touch tissue image,VTI)and VTQ(virtual touch tissue quantification,VTQ).Analysised the conventional ultrasonic ultrasonographic characteristics: the nodule shape,margin,internal echo,internal microcalcification,intranodular blood flow,peripheral halo sign,anteroposterior to transverse diameter ratio with thyroid nodules.The relatively elastic gray image showing the thyroid nodule with its surrounding tissue was obtained through the VTI examination.The six levels of graded method of VTI image was used to determine the nodule property.Through the VTQ inspection with the thyroid nodule and its surrounding normal tissue in same depth,the shear wave velocity of the nodule and its surrounding normal tissue with the same depth was obtained.Draw the receiver operating characteristic curve of the score of the grade of VTI,SWV(shear wave velocity,SWV)to find out the best boundary value of the grade of VTI,SWV in diagnosis of malignant tumor.With the pathologic results of thyroid nodules as the gold standard,the ability of differential diagnosis of benign and malignant thyroid nodules of VTI and VTQ inspection was calculated.Results: With pathologic results of thyroid nodules as the gold standard,59 nodules of the 92 thyroid nodules were benign,the other 33 nodules were malignant.The sensitivity,specificity,the accuracy of Conventional ultrasonographic characteristics: the nodule shape,margin,internal echo,internal microcalcification,intranodular blood flow,peripheral halo sign,anteroposterior to transverse diameter ratio in the diagnosis of thyroid nodules were 91.4%?68.4%?77.2%,77.1%?82.5%?80.4%,62.9%?89.5%?79.3%,62.9%?91.2%?80.4%,71.4%?86.0%?35.9%,88.6%?63.2%?72.8%,34.3% ? 96.5% ? 72.8% respectively.The area under the ROC(receiver operating characteristic,ROC)curve of VTI was 0.952.The sensitivity,specificity and the accuracy of VTI in the diagnosis of thyroid nodules were 88.6%?93.0% and 91.3% respectively.The area under the ROC curve of VTQ was 0.797.The best boundary SWV value of the differential diagnosis of benign and malignant thyroid nodules was 2.74m/s.The sensitivity,specificity and the accuracy of VTQ in the diagnosis of thyroid nodules were 54.28%,92.98% and 78.26% respectively.Conclusion: Compared with conventional ultrasonograph,the value of virtual touch tissue quantification technology for differentiating between benign and malignant thyroid nodule has shown no obvious advantage.On the basis of conventional ultrasound,VTI in the differential diagnosis of benign and malignant thyroid nodules has a certain value.