Use of Shear Wave Elastography in the Sonographic Triage of Thyroid Nodules: Feasibility Study in a Series of Lesions Already Selected for Fine Needle Aspiration

Objectives—The aim of this study was to evaluate the application of shear waveelastography (SWE) in the routine management of thyroid nodules, as a possibleadditional tool to the standard sonographic triage.Methods—A total of 248 consecutive patients scheduled for ultrasound-guidedthyroidfine-needle aspiration were included in the study. The presence of a purecolloid lesion was an exclusion criterion. Absolute and relative SWE stiffnessmeasurements on color-coded elastograms, expressed in kilopascals and metersper second, were correlated with radiologic and pathologic features.Results—SWE values in thyroid nodules were significantly higher than normalthyroid tissue (P= .0001), proving the different elastic properties of the patho-logic tissues. Regarding the radiologic characteristics of the nodules, SWE high-est values were associated with the largest lesions (P= .0105) but independentfrom sonographic and Dopplerfindings. The SWE elasticity was not influencedby the characteristics of the biopsy smears. Thefinal correlation between theSWE results and the pathologic diagnoses showed a trend in stiffness fromtender tumors (follicular adenoma) to papillary thyroid carcinoma (P= .016).Conclusions—SWE allows the identification of nodules within normal paren-chyma; however, the present study does not confirm the potential role in differ-entiating between benign and malignant thyroid nodules.