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Original research article


Elastography-targeted Thyroid Nodule Aspiration: A Novel Approach

Elliot Landau1Danielle Del Re1Bina Kviatkovsky1Aryeh Rothstein2Jonathan Scheiner1Cheryl Lin1
1Department of Radiology, Staten Island University Hospital, Staten Island, Touro College of Osteopathic Medicine, 2Yeshiva University, New York, NY, USA
Date of Submission: 28-Sep-2016, Date of Acceptance: 29-Dec-2016, Date of Web Publication: 27-Jan-2017.
Corresponding Author:
Corresponding Author

Elliot Landau

Department of Radiology, Staten Island University Hospital, 475 Seaview Avenue, Staten Island, New York, 10305 NY, USA.
E-mail: elliotlandau2@gmail.com

Corresponding Author:
Corresponding Author

Elliot Landau

Department of Radiology, Staten Island University Hospital, 475 Seaview Avenue, Staten Island, New York, 10305 NY, USA.
E-mail: elliotlandau2@gmail.com

DOI: 10.4103/2156-7514.199054 Facebook Twitter Google Linkedin

ABSTRACT


Objectives: Since 2009, the rate of nondiagnostic (ND) thyroid nodule fineneedle aspiration (FNA) has ranged from 2% to 20%. A ND result can cause further patient morbidity secondary to repeated procedures and delay in diagnosis. The use of real-time strain elastography (RTE) in determining nodule malignant risk has gained considerable focus recently. A less studied area where RTE may prove beneficial is its role in targeting areas for FNA. Our hypothesis is that FNA performed in concurrence with RTE will show a decreased rate of ND results leading to fewer repeated FNA. Materials and Methods: The Institutional Review Board approval was obtained. A retrospective review of all thyroid nodule FNA from January 1, 2011, to January 1, 2014, was performed with review of nodule size, presence of microcalcifications, vascularity, solid components, patient age, and gender. Cases were separated based if RTE was done before FNA or not. Pathology reports were reviewed to assess for specimen adequacy. Statistical comparison was performed using SAS analysis software. Results: A total of 221 specimens were reviewed, with RTE performed on 140 cases (63.4%). Both groups were similar in demographics and previously described nodule characteristics. The ND rate when RTE was not performed was 16% (13/68) compared to 10% when RTE was performed (14/126). The difference was not found to be statistically significant, P = 0.205. Conclusions: The presence of an elastogram failed to demonstrate a significant decrease in ND FNA rates although these results may be secondary to study design. Further evaluation with prospective trials using larger sample size may ultimately detect increased accuracy of RTE-targeted FNA.
Keywords: Elastography, Fine‑needle aspiration, Nondiagnostic, Thyroid nodule, Ultrasound

Cited in 1 Document

  1. A.S. McQueen and K.S. Bhatia (2018) Head and neck ultrasound: technical advances, novel applications and the role of elastography. Clinical Radiology 73(1):81. doi: 10.1016/j.crad.2017.08.003

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