Diagnostic Value Of Virtual Touch Tissue Quantification And Thyroid Imaging Reporting And Date System For Benign Or Malignant Thyroid Nodule

Objective: To evaluate the differential diagnostic value of virtual touch tissue quantification(VTQ),thyroid imaging reporting and date system(TI-RADS)and VTQ combined with TI-RADS for benign or malignant thyroid nodule,in order to find fresh ways for the qualitative diagnosis of thyroid nodule.Methods: From December 2015 to December 2016,a total of 108Patients with 142 pathological confirmed thyroid nodules were performed of conventional ultrasound,the 142 nodules were classified with TI-RADS standard,grade 2~3 were diagnosis as benign nodules,grade 4~5 were diagnosis as malignant nodules,then the shear wave velocities(SWV)of the 142 nodules were measured by VTQ technology.The application of combined methods,VTQ diagnosis as benign nodules,TI-RADS grade minus one level,VTQ diagnosis as malignant nodules,TI-RADS grade plus one level,the new grade 2~3 were diagnosis as benign nodules,grade 4~5 were diagnosis as malignant nodules(original TI-RADS grade 2,5 were still diagnosed as the original grade).Taking surgical pathology as the gold standard,the diagnostic accuracy,sensitivity,specificity,positive predictive value(PPV)and negative predictive value(NPV)of VTQ,TI-RADS standard and their Combination were calculated respectively.The ROC of VTQ,TI-RADS standard and their combination were drawn,and the AUC was compared among groups.Results: One hundred and forty-two nodules included 87 benign lesions and 55 malignant lesions.53 nodules were classified as malignant and 89 as benign by VTQ,46 nodules were classified as malignant and 89 as benign by TI-RADS standard,57 nodules were classified as malignant and 85 as benign by combined VTQ with TI-RADS standard.The accuracy,sensitivity,specificity,PPV,NPV and 95%CI of VTQ was 88.02%(125/142),83.33%(45/54),90.90%(80/88),84.90%(45/53),89.88%(80/89),95%CI(0.743,0.907),respectively;The accuracy,sensitivity,specificity,PPV,NPV and 95%CI of TI-RADS standard was 83.80%(119/142),70.90%(39/55),91.95%(80/87),84.78%(39/46),83.33%(80/96),95%CI(0.755,0.903),respectively;The accuracy,sensitivity,specificity,PPV,NPV and 95%CI of VTQ combined with TI-RADS standard was 88.02%(125/142),89.09%(49/55),87.35%(76/87),81.66%(49/60),92.68%(76/82),95%CI(0.896,0.981),respectively.The area under the ROC curves of VTQ,TI-RADS standard and their combination was 0.825,0.828,0.939,respectively.Conclusion: VTQ can quantitatively reflect the elastic modulus of thyroid nodules,and it has high clinical value in the differential diagnosis of benign or malignant thyroid nodule,VTQ and TI-RADS standard each has its own advantages,but their combination could improve the practical value of differentiating diagnosis of thyroid nodules.