New methods of imaging thyroid gland
Journal Title: Postępy Nauk Medycznych - Year 2013, Vol 26, Issue 11
Abstract
Traditional methods of imaging thyroid gland are radionuclide scan with the use of either 99Tc pertechnetate, 123I or 131I and ultrasonography (US). Nowadays a new technique, elastography (ES) arouses a great interest. Basing on the fact that malignant tissue is usually hard on palpation ES was introduced to estimate tissue stiffness. Two main forms of ES are known in clinical practice: strain ES which evaluates the tissue stiffness by the external compression with probe or by endogenous compression exerted by carotid artery pulsation. The degree of tissue deformation under compression is color-coded: from red to blue. The strain ratio between a lesion and adjacent healthy thyroid tissue is also used. The second ES form is shear wave elastography (SWE) which measures the speed of the transverse wave in tissues: the speed of shear wave is higher in malignant nodules than in benign lesions. The results of SWE are expressed in m/s or kPa. The reported results are promising: ES can predict thyroid malignancy with 82-97% sensitivity, 96-100% specificity, 87-94% PPV and 85-98% NPV. The results of evaluating indeterminate nodules are conflicting: PPV of 34-81%, NPV of 50-89.9%. Although the accuracy of ES in differentiating thyroid nodules is better than conventional US, it has limitations: peripheral or intralesional calcifications, large cystic areas within the nodule and follicular cancers. Another method – 18fluoro-D-glucose positron emission tomography scanning has proven role in the localization of differentiated thyroid cancer metastases in Tg-positive, RAI scan – negative patients and also can be used to differentiate the nodules with indeterminate cytology.
Authors and Affiliations
Małgorzata Gietka-Czernel
Keywords
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