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Differential Diagnosis of Thyroid Nodules with US Elastography Using Carotid Artery Pulsation¹

¹ From the Departments of Radiology (M.D., M.L.R., T.J.D., S.M.), Electrical Engineering (U.B.), and Bioengineering (Y.K.), University of Washington Medical Center, Box 357115, 1959 NE Pacific St, Seattle, WA 98195. From the 2006 RSNA Annual Meeting. Received October 4, 2007; revision requested November 27; revision received January 5, 2008; accepted February 18; final version accepted March 3. Address correspondence to M.D. (e-mail: dighe{at}u.washington.edu).

Purpose: To explore the sensitivity and specificity of ultrasonographic (US) elastography using carotid arterial pulsation as the compression source for differential diagnosis of thyroid nodules.

Materials and Methods: This HIPAA-compliant study was approved by the ethics committee of the institution, and all patients provided written informed consent. Fifty-eight patients (13 men and 45 women [mean age, 51 years; range, 20–76 years]) were enrolled. A short US examination and elastography with pulsation of the carotid artery used as the thyroid compression source were performed before fine-needle aspiration. Baseband US data were downloaded for off-line analysis. Elastographic maps and the thyroid stiffness index were calculated. The Kruskal-Wallis nonparametric rank sum test was used to assess equality of population medians among the different types of thyroid nodules; the R software environment was used for statistical computing and graphics (http://www.r-project.org/).

Results: Thyroid stiffness index calculated with elastography using carotid arterial pulsation as the compression source was effective in helping distinguish between papillary carcinomas (n = 10) and other lesions (n = 43) because papillary carcinomas were stiffer than other lesions (P < .0039).

Conclusion: It is possible to distinguish between papillary carcinomas and other lesions with the thyroid stiffness index calculated from US elastography using carotid arterial pulsation.

© RSNA, 2008