Purpose: The diagnosis and management of follicular cancer of the thyroid gland remains a controversial topic. The aim of this study was to evaluate the clinical usefulness of Elastography imaging for the differential diagnosis of thyroid follicular lesions.
Methods and Materials: 133 follicular tumors were examined by Elastography. Papillary cancers, other types thyroid malignancies or hot nodules were excluded from this study. The images of thyroid follicular lesions were recognized as four typical patterns as follows: Pattern 1(P1): nodule is relatively homogenous and colored with light green. Pattern 2(P2): the center of nodule is colored with green and its periphery is colored with blue. Pattern 3(P3): nodule is mixed-colored with light green and red. Pattern 4(P4): the whole tumor is displayed in blue.
Results: All the follicular tumors were surgically and histopathologically diagnosed finally. In this series, 58 hyperplastic nodules, 33 follicular adenomas and 42 follicular cancers (28 Minimally invasive, 14 Widely invasive) were found. Of the 42 follicular cancers, 31 cases were P2, which was occupied 73.8%. Assuming Pattern 2 to be malignant and others to be benign, 87 of 91 benign tumors and 31 of 42 follicular cancers were accurately diagnosed, yielding a sensitivity of 78.8%, a specificity of 95.6%, and an accuracy of 90.2%.
Conclusion: Elastography can provide new useful information for the differential diagnosis of thyroid follicular tumors and has a capability to improve the diagnostic specificity and accuracy than that of our former studies of color-Doppler examination.