Vascularity, elastography in suspicious TIRADS scores may differentiate malignant thyroid nodules

According to Aghaghazvini et al., patient mean age was 53 years; 105 were men [52.5%]. And of 27 [13.5%] total nodules with malignancy in their study, 14 [7%] were papillary thyroid carcinoma, 11 [5.5%] were follicular thyroid carcinoma, and 2 [1%] were medullary thyroid cancer. AUC of the ROC curve for TIRADS assessment was 0.76. Results found 37 [18.5%] TIRADS 4 nodules, wherein 15 [40.5%] were malignant, and 57 [28.5%] TIRADS 5 nodules, 12 [21.1%] of which were malignant.

In only TIRADS 4 nodules, Doppler grade AUC, RI, color map elastography grade, SWE maximum velocity, and mean SWE velocity for diagnosing malignancy were 0.8, 0.93, 0.89, 0.86, and 0.82, respectively. Meanwhile, profiles in TIRADS 5-only nodules were 0.8, 0.96, 0.85, 0.96, and 0.97, respectively. Additionally, in TIRADS 4, an RI cutoff point of 0.6 yielded diagnostic efficacy indices of 0.93, 1, 0.97, 1, and 0.96 for sensitivity, specificity, efficiency, PPV and NPV, respectively. In TIRADS 5 nodules, a cutoff point of 4.33 for SWE mean velocity yielded diagnostic efficacy indices of 1, 0.82, 0.86, 0.6, and 1 for sensitivity, specificity, efficiency, PPV and NPV, respectively.