Elastography in the Differential Diagnosis of Thyroid Nodules in Hashimoto thyroiditis

Program: Abstracts - Orals, Featured Poster Presentations, and Posters
Session: MON 471-496-Thyroid Neoplasia & Case Reports
Monday, June 17, 2013: 1:45 PM-3:45 PM
Expo Halls ABC (Moscone Center)

Poster Board MON-486
Mustafa Sahin*1, Erman Cakal2, Mustafa Ozbek2, Askin Gungunes2, Müyesser Sayki Arslan2, Esra tutal Kaymak2, Bekir Ucan2, Ilknur ünsal2, Nujen Colak Bozkurt2 and Tuncay Delibasi2
1Ankara University Faculty of Medicine, Ankara, Turkey, 2Diskapi Yildirim Beyazit Training and Research Hospital, Ankara, Turkey
Elastography is a method which assesses the risk of malignancy and provides information about the degree of hardness in tissue. Malignant nodules elastography score (ES) and strain index (SI) are determined to be high. Hashimoto's thyroiditis, autoimmune lymphocytic infiltration and fibrosis is considered to be a very common disease able to change the hardness of the tissue. The diagnostic value of elastography of this group of patients has not previously been reported. In our study, we aimed to determine the diagnostic value of elastography in 283 patients (255 female, 28 male) with Hashimoto's thyroiditis.  Hashimoto thyroiditis patients with single nodule, planned to go thyroid fine-needle aspiration biopsy (TİAB) are included in the study. Elastography score and index were measured with Real time ultrasound elastography (Hitachi® EUB 7000 HV machine with using 13 MHz linear transducer). The outcome of this measure shows that Malignant nodules were higher ES and SI values. ES greater and equal to 3 were observed in 16/20 malignant and 130/263 benign nodules respectively. The area under the curve (AUC) for the elasto score (AUC) was 0,72 (p=0,001) and AUC for the strain index was 0,77 (p< 0.0001). Accordingly, our study suggests that strain index reflects malignancy better than the elasto score. We conclude that elastography score is greater or equal to 3 providing % 80 sensitivity and % 50, 6 specifity for diagnosing malignancy. For strain index we found that 2, 45 (% 72.2 sensitivity and % 70 specifity) is a cut-off point. We have detected a lower cut-off point for SI in Hashimoto patients. Although sensitivity and specificity decreses in Hashimoto patients, elastography may still be helpful to detect malignancy in this population.

Nothing to Disclose: MS, EC, MO, AG, MSA, ETK, BU, I, NCB, TD

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