WFUMB Guidelines and Recommendations on the Clinical Use of Ultrasound Elastography: Part 4. Thyroid.

The World Federation for Ultrasound in Medicine and Biology (WFUMB) has produced guidelines for the use of elastography techniques including basic science, breast and liver. Here we present elastography in thyroid diseases. For each available technique, procedure, reproducibility, results and limitations are analyzed and recommendations are given. Finally, recommendations are given based on the level of evidence of the published literature and on the WFUMB expert group's consensus. The document has a clinical perspective and is aimed at assessing the usefulness of elastography in the management of thyroid diseases.

[1]  F. Sebag,et al.  A threshold value in Shear Wave elastography to rule out malignant thyroid nodules: a reality? , 2012, European journal of radiology.

[2]  Yongmin Kim,et al.  Elastography can effectively decrease the number of fine-needle aspiration biopsies in patients with calcified thyroid nodules. , 2014, Ultrasound in medicine & biology.

[3]  Xuemei Wang,et al.  Real‐time Ultrasound Elastography for Differentiation of Benign and Malignant Thyroid Nodules , 2014, Journal of ultrasound in medicine : official journal of the American Institute of Ultrasound in Medicine.

[4]  Tsuyoshi Shiina,et al.  WFUMB guidelines and recommendations for clinical use of ultrasound elastography: Part 3: liver. , 2015, Ultrasound in medicine & biology.

[5]  Xiaoxi Li,et al.  Diagnostic performance of shear wave elastography in the identification of malignant thyroid nodules: a meta-analysis , 2014, European Radiology.

[6]  Ming-de Lu,et al.  Shear wave elastography versus real-time elastography on evaluation thyroid nodules: a preliminary study. , 2014, European journal of radiology.

[7]  Kaliszewski,et al.  American Thyroid Association Management Guidelines for Adult Patients with Thyroid Nodules and Differentiated Thyroid Cancer : The American Thyroid Association Guidelines Task Force on Thyroid Nodules and Differentiated Thyroid Cancer , 2017 .

[8]  Hui-Xiong Xu,et al.  Quantitative Shear Wave Velocity Measurement on Acoustic Radiation Force Impulse Elastography for Differential Diagnosis between Benign and Malignant Thyroid Nodules: A Meta-analysis. , 2015, Ultrasound in medicine & biology.

[9]  Yongmin Kim,et al.  Differential diagnosis of thyroid nodules with US elastography using carotid artery pulsation. , 2008, Radiology.

[10]  A. Ahuja,et al.  Clinical significance of the comet‐tail artifact in thyroid ultrasound , 1996, Journal of clinical ultrasound : JCU.

[11]  Kazimierz T. Szopinski,et al.  Shear Wave Elastography May Add a New Dimension to Ultrasound Evaluation of Thyroid Nodules: Case Series with Comparative Evaluation , 2012, Journal of thyroid research.

[12]  H. Gharib,et al.  AACE / AME / ETA Guidelines AMERICAN ASSOCIATION Of ClINICAl ENDOCRINOlOgISTS , ASSOCIAzIONE MEDICI ENDOCRINOlOgI , AND EuROPEAN ThyROID ASSOCIATION MEDICAl guIDElINES fOR ClINICAl PRACTICE fOR ThE DIAgNOSIS AND MANAgEMENT Of ThyROID NODulES , 2010 .

[13]  Hui-Xiong Xu,et al.  Acoustic radiation force impulse elastography for differentiation of benign and malignant thyroid nodules with concurrent Hashimoto’s thyroiditis , 2015, Medical Oncology.

[14]  E. Aktaş,et al.  The utility of ultrasound elastography and MicroPure imaging in the differentiation of benign and malignant thyroid nodules. , 2012, AJR. American journal of roentgenology.

[15]  S. Bota,et al.  Thyroid Stiffness Assessment by Acoustic Radiation Force Impulse Elastography (ARFI) , 2011, Ultraschall in der Medizin.

[16]  D. Carneiro-Pla Ultrasound elastography in the evaluation of thyroid nodules for thyroid cancer , 2013, Current opinion in oncology.

[17]  Sukru Mehmet Erturk,et al.  Q-Elastosonography of Solid Thyroid Nodules: Assessment of Diagnostic Efficacy and Interobserver Variability in a Large Patient Cohort , 2013, European Radiology.

[18]  M F Neurath,et al.  An abdominal and thyroid status with Acoustic Radiation Force Impulse Elastometry--a feasibility study: Acoustic Radiation Force Impulse Elastometry of human organs. , 2011, European journal of radiology.

[19]  Kyunghwa Han,et al.  Diagnostic Role of Conventional Ultrasonography and Shearwave Elastography in Asymptomatic Patients with Diffuse Thyroid Disease: Initial Experience with 57 Patients , 2013, Yonsei medical journal.

[20]  Eun Ju Son,et al.  Quantitative assessment of shear-wave ultrasound elastography in thyroid nodules: diagnostic performance for predicting malignancy , 2013, European Radiology.

[21]  Jianming Wang,et al.  Ultrasound scoring in combination with ultrasound elastography for differentiating benign and malignant thyroid nodules , 2015, Clinical endocrinology.

[22]  T. Şahin,et al.  The value of real-time ultrasound elastography in chronic autoimmune thyroiditis. , 2014, The British journal of radiology.

[23]  M. Castellano,et al.  Real‐time Elastography , 2012, Journal of ultrasound in medicine : official journal of the American Institute of Ultrasound in Medicine.

[24]  A. Pinchera,et al.  Combined clinical, thyroid ultrasound and cytological features help to predict thyroid malignancy in follicular and Hϋrthle cell thyroid lesions: results from a series of 505 consecutive patients , 2006, Clinical endocrinology.

[25]  M. Reus,et al.  Interobserver Agreement for Thyroid Elastography , 2013, Journal of ultrasound in medicine : official journal of the American Institute of Ultrasound in Medicine.

[26]  Yongmin Kim,et al.  Interobserver agreement and intraobserver reproducibility in thyroid ultrasound elastography. , 2012, AJR. American journal of roentgenology.

[27]  Cong Shuzhen,et al.  Comparison analysis between conventional ultrasonography and ultrasound elastography of thyroid nodules. , 2012, European journal of radiology.

[28]  Tao Zhang,et al.  The value of strain ratio in differential diagnosis of thyroid solid nodules. , 2012, European journal of radiology.

[29]  Fengjuan Zhang,et al.  The value of acoustic radiation force impulse (ARFI) in the differential diagnosis of thyroid nodules. , 2013, European journal of radiology.

[30]  Ah Young Park,et al.  Shear wave elastography of thyroid nodules for the prediction of malignancy in a large scale study. , 2015, European journal of radiology.

[31]  H-J Dan,et al.  Differential Diagnosis of Small Single Solid Thyroid Nodules using Real-Time Ultrasound Elastography , 2010, The Journal of international medical research.

[32]  Eriko Matsuda,et al.  Phantom experiment and clinical utility of quantitative shear wave elastography for differentiating thyroid nodules. , 2014, Endocrine journal.

[33]  Stephanie L. Lee,et al.  Revised American Thyroid Association management guidelines for patients with thyroid nodules and differentiated thyroid cancer. , 2009, Thyroid : official journal of the American Thyroid Association.

[34]  Carlo Catalano,et al.  Strain US Elastography for the Characterization of Thyroid Nodules: Advantages and Limitation , 2015, International journal of endocrinology.

[35]  J. Kwak Thyroid Imaging Reporting and Data System (TIRADS) , 2013 .

[36]  Han Liu,et al.  The application of Virtual Touch tissue quantification (VTQ) in diagnosis of thyroid lesions: a preliminary study. , 2013, European journal of radiology.

[37]  C. Chabrolle,et al.  [Elastosonography of thyroid lesions]. , 2008, Journal de radiologie.

[38]  Jing Li,et al.  Could ultrasonic elastography help the diagnosis of breast cancer with the usage of sonographic BI-RADS classification? , 2012, European journal of radiology.

[39]  Yongmei Sun,et al.  Diagnostic value of strain ratio measurement in differential diagnosis of thyroid nodules coexisted with Hashimoto thyroiditis. , 2015, International journal of clinical and experimental medicine.

[40]  C. Göya,et al.  Acoustic Radiation Force Impulse (ARFI) imaging for the distinction between benign and malignant thyroid nodules , 2015, La radiologia medica.

[41]  V. Cantisani,et al.  Prospective evaluation of acoustic radiation force impulse technology in the differentiation of thyroid nodules: accuracy and interobserver variability assessment , 2014, Journal of Ultrasound.

[42]  T. Mitake,et al.  REAL-TIME ELASTOGRAPHY AND CONTRAST-ENHANCED ULTRASOUND FOR THE ASSESSMENT OF THYROID NODULES , 2010 .

[43]  F. Sebag,et al.  What is the contribution of elastography to thyroid nodules evaluation? , 2011, Annales d'endocrinologie.

[44]  Eriko Matsuda,et al.  Utility of Shear Wave Elastography for Diagnosing Chronic Autoimmune Thyroiditis , 2015, Journal of thyroid research.

[45]  D. Cosgrove,et al.  Ultrasound Elastography in Breast Cancer Diagnosis , 2015, Ultraschall in der Medizin.

[46]  K. Togashi,et al.  Thyroid gland tumor diagnosis at US elastography. , 2005, Radiology.

[47]  C. Dietrich,et al.  [Ultrasound of the thyroid]. , 2015, Zeitschrift fur Gastroenterologie.

[48]  Hui-Xiong Xu,et al.  Virtual Touch Tissue Imaging on Acoustic Radiation Force Impulse Elastography , 2014, Journal of ultrasound in medicine : official journal of the American Institute of Ultrasound in Medicine.

[49]  Yu-rong Hong,et al.  Real‐time Ultrasound Elastography in the Differential Diagnosis of Benign and Malignant Thyroid Nodules , 2009, Journal of ultrasound in medicine : official journal of the American Institute of Ultrasound in Medicine.

[50]  Ann D King,et al.  Real-time qualitative ultrasound elastography of miscellaneous non-nodal neck masses: applications and limitations. , 2010, Ultrasound in medicine & biology.

[51]  C. Catalano,et al.  Diagnostic Accuracy and Interobserver Agreement of Quasistatic Ultrasound Elastography in the Diagnosis of Thyroid Nodules , 2014, Ultraschall in der Medizin.

[52]  C. Leitão,et al.  Thyroid Ultrasound Features and Risk of Carcinoma: A Systematic Review and Meta-Analysis of Observational Studies , 2015, Thyroid : official journal of the American Thyroid Association.

[53]  M. Ruchała,et al.  Sonoelastography in de Quervain thyroiditis. , 2011, The Journal of clinical endocrinology and metabolism.

[54]  R. Jeffrey,et al.  Management of thyroid nodules detected at US: Society of Radiologists in Ultrasound consensus conference statement. , 2005, Ultrasound quarterly.

[55]  Hai-ling Wang,et al.  Application of Real-time Ultrasound Elastography in Diagnosing Benign and Malignant Thyroid Solid Nodules , 2012, Cancer biology & medicine.

[56]  Le-Hang Guo,et al.  Virtual Touch Tissue Quantification of Acoustic Radiation Force Impulse: A New Ultrasound Elastic Imaging in the Diagnosis of Thyroid Nodules , 2012, PloS one.

[57]  T. Matsumura,et al.  Breast disease: clinical application of US elastography for diagnosis. , 2006, Radiology.

[58]  C. Catalano,et al.  Q-Elastography in the Presurgical Diagnosis of Thyroid Nodules with Indeterminate Cytology , 2012, PloS one.

[59]  M. Ostrowski,et al.  The thyroid: review of imaging features and biopsy techniques with radiologic-pathologic correlation. , 2014, Radiographics : a review publication of the Radiological Society of North America, Inc.

[60]  Min Bai,et al.  Preliminary Study on the Diagnostic Value of Acoustic Radiation Force Impulse Technology for Differentiating Between Benign and Malignant Thyroid Nodules , 2012, Journal of ultrasound in medicine : official journal of the American Institute of Ultrasound in Medicine.

[61]  Ping Xing,et al.  Differentiation of Benign From Malignant Thyroid Lesions , 2011, Journal of ultrasound in medicine : official journal of the American Institute of Ultrasound in Medicine.

[62]  Paolo Vitti,et al.  Role of thyroid ultrasound in the diagnostic evaluation of thyroid nodules. , 2008, Best practice & research. Clinical endocrinology & metabolism.

[63]  T. Rago,et al.  Potential value of elastosonography in the diagnosis of malignancy in thyroid nodules. , 2009, The quarterly journal of nuclear medicine and molecular imaging : official publication of the Italian Association of Nuclear Medicine (AIMN) [and] the International Association of Radiopharmacology (IAR), [and] Section of the Society of....

[64]  T. Fahey Utility and Interobserver Agreement of Ultrasound Elastography in the Detection of Malignant Thyroid Nodules in Clinical Care , 2012 .

[65]  A. Morabito,et al.  US-elastography in the differential diagnosis of benign and malignant thyroid nodules. , 2008, Thyroid : official journal of the American Thyroid Association.

[66]  Grzegorz Kaminski,et al.  The role of sonoelastography in acute, subacute and chronic thyroiditis: a novel application of the method. , 2012, European journal of endocrinology.

[67]  Eva Herrmann,et al.  Acoustic Radiation Force Impulse-Imaging for the evaluation of the thyroid gland: a limited patient feasibility study. , 2012, Ultrasonics.

[68]  Jianrui Ding,et al.  Quantitative Measurement for Thyroid Cancer Characterization Based on Elastography , 2011, Journal of ultrasound in medicine : official journal of the American Institute of Ultrasound in Medicine.

[69]  Yongmin Kim,et al.  Ultrasound Thyroid Elastography Using Carotid Artery Pulsation , 2007, Journal of ultrasound in medicine : official journal of the American Institute of Ultrasound in Medicine.

[70]  L. Hegedüs Can elastography stretch our understanding of thyroid histomorphology? , 2010, The Journal of clinical endocrinology and metabolism.

[71]  Yun Zhang,et al.  Virtual touch tissue quantification (VTQ) in the diagnosis of thyroid nodules with coexistent chronic autoimmune Hashimoto's thyroiditis: a preliminary study. , 2015, European journal of radiology.

[72]  M. Rotondi,et al.  Shear wave elastography in the diagnosis of thyroid nodules: feasibility in the case of coexistent chronic autoimmune Hashimoto’s thyroiditis , 2012, Clinical endocrinology.

[73]  Hui-Xiong Xu,et al.  Acoustic Radiation Force Impulse Elastography in the Diagnosis of Thyroid Nodules: Useful or Not Useful? , 2015, Ultrasound in medicine & biology.

[74]  Xiao-yan Xie,et al.  Shear Wave Elastography in the Diagnosis of Thyroid Nodules with Coexistent Chronic Autoimmune Hashimoto’s Thyroiditis , 2015, Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery.

[75]  Jan Wolff,et al.  Real-time ultrasound elastography—a noninvasive diagnostic procedure for evaluating dominant thyroid nodules , 2010, Langenbeck's Archives of Surgery.

[76]  J. Charboneau,et al.  Sonography of Thyroid Nodules: A “Classic Pattern” Diagnostic Approach , 2005, Ultrasound quarterly.

[77]  Angela Cepero Calvete,et al.  Acoustic Radiation Force Impulse Imaging for Evaluation of the Thyroid Gland , 2014, Journal of ultrasound in medicine : official journal of the American Institute of Ultrasound in Medicine.

[78]  Jin Young Kwak,et al.  Thyroid imaging reporting and data system for US features of nodules: a step in establishing better stratification of cancer risk. , 2011, Radiology.

[79]  O. Hélénon,et al.  [Imaging of thyroid nodules]. , 1999, Journal de radiologie.

[80]  J. Sipos,et al.  Advances in ultrasound for the diagnosis and management of thyroid cancer. , 2009, Thyroid : official journal of the American Thyroid Association.

[81]  A. Ahuja,et al.  Lumps and Bumps in the Head and Neck , 2000 .

[82]  Ryoji Kagoya,et al.  Utility of elastography for differential diagnosis of benign and malignant thyroid nodules , 2010, Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery.

[83]  Giovanni Guido Cerri,et al.  Thyroid nodules: Evaluation with power Doppler and duplex Doppler ultrasound , 2005, Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery.

[84]  A. King,et al.  Cystic change in thyroid nodules: a confounding factor for real-time qualitative thyroid ultrasound elastography. , 2011, Clinical radiology.

[85]  S. Dudea,et al.  Ultrasound elastography in thyroid disease. , 2015, Medical ultrasonography.

[86]  B. Han,et al.  Ultrasonographic elastography of thyroid nodules: is adding strain ratio to colour mapping better? , 2013, Clinical radiology.

[87]  S. Bota,et al.  ARFI elastography for the evaluation of diffuse thyroid gland pathology: Preliminary results. , 2012, World journal of radiology.

[88]  M. Andrioli,et al.  Elastographic techniques of thyroid gland: current status , 2014, Endocrine.

[89]  Le-Hang Guo,et al.  Solid hypo-echoic thyroid nodules on ultrasound: the diagnostic value of acoustic radiation force impulse elastography. , 2014, Ultrasound in medicine & biology.

[90]  Jin Young Kwak,et al.  Interobserver agreement in assessing the sonographic and elastographic features of malignant thyroid nodules. , 2009, AJR. American journal of roentgenology.

[91]  Hui-Xiong Xu,et al.  Acoustic Radiation Force Impulse Imaging: A New Tool for the Diagnosis of Papillary Thyroid Microcarcinoma , 2014, BioMed research international.

[92]  M. Schott,et al.  US-Elastography in the Differential Diagnosis of Benign and Malignant Thyroid Nodules , 2009 .

[93]  M. Erdoğan,et al.  Ultrasound elastography is not superior to grayscale ultrasound in predicting malignancy in thyroid nodules. , 2012, Thyroid : official journal of the American Thyroid Association.

[94]  Eriko Matsuda,et al.  Correlation between quantitative shear wave elastography and pathologic structures of thyroid lesions. , 2015, Ultrasound in medicine & biology.

[95]  Tsuyoshi Shiina,et al.  WFUMB guidelines and recommendations for clinical use of ultrasound elastography: Part 2: breast. , 2015, Ultrasound in medicine & biology.

[96]  M. Danacı,et al.  Comparison of muscle-to-nodule and parenchyma-to-nodule strain ratios in the differentiation of benign and malignant thyroid nodules: which one should we use? , 2014, European journal of radiology.

[97]  Roberto Garberoglio,et al.  High diagnostic accuracy and interobserver reliability of real-time elastography in the evaluation of thyroid nodules. , 2012, Ultrasound in medicine & biology.

[98]  F. Sebag,et al.  Shear wave elastography: a new ultrasound imaging mode for the differential diagnosis of benign and malignant thyroid nodules. , 2010, The Journal of clinical endocrinology and metabolism.

[99]  R. Álvarez-San Martín,et al.  Accuracy of ultrasound elastography in the diagnosis of thyroid cancer in a low-risk population. , 2012, Experimental and clinical endocrinology & diabetes : official journal, German Society of Endocrinology [and] German Diabetes Association.

[100]  Xinming Zhao,et al.  The value of virtual touch tissue image (VTI) and virtual touch tissue quantification (VTQ) in the differential diagnosis of thyroid nodules. , 2014, European journal of radiology.

[101]  Ricardo Rossi,et al.  An ultrasonogram reporting system for thyroid nodules stratifying cancer risk for clinical management. , 2009, The Journal of clinical endocrinology and metabolism.

[102]  S. Bota,et al.  Real-time shear wave elastography may predict autoimmune thyroid disease , 2015, Wiener klinische Wochenschrift.

[103]  Ying Xiao,et al.  Real‐time ultrasound elastography in the diagnosis and differential diagnosis of subacute thyroiditis , 2011, Journal of clinical ultrasound : JCU.

[104]  F. Dong,et al.  Acoustic Radiation Force Impulse imaging for detecting thyroid nodules: a systematic review and pooled meta-analysis. , 2015, Medical ultrasonography.

[105]  Jia Zhan,et al.  Acoustic radiation force impulse imaging (ARFI) for differentiation of benign and malignant thyroid nodules--A meta-analysis. , 2015, European journal of radiology.

[106]  T. Delibaşı,et al.  Elastography in the differential diagnosis of thyroid nodules in Hashimoto thyroiditis , 2014, Medical Oncology.

[107]  O H Gilja,et al.  EFSUMB Guidelines and Recommendations on the Clinical Use of Ultrasound Elastography.Part 2: Clinical Applications , 2013, Ultraschall in der Medizin.

[108]  Jung Hee Shin,et al.  Sonography of thyroid nodules with peripheral calcifications , 2009, Journal of clinical ultrasound : JCU.

[109]  Anil T. Ahuja,et al.  Shear wave elastography of thyroid nodules in routine clinical practice: preliminary observations and utility for detecting malignancy , 2012, European Radiology.

[110]  E. Jung,et al.  Role Of Ultrasonography in Predicting Malignancy in Patients with Thyroid Nodules , 2007, World Journal of Surgery.

[111]  C. Catalano,et al.  Ultrasound elastography in the evaluation of thyroid pathology. Current status. , 2014, European journal of radiology.

[112]  Ioan Sporea,et al.  EFSUMB Guidelines and Recommendations on the Clinical , 2017 .

[113]  M. Shakiba,et al.  Diagnostic accuracy of sonoelastography in detecting malignant thyroid nodules: a systematic review and meta-analysis. , 2014, AJR. American journal of roentgenology.

[114]  Manish Dhyani,et al.  Shear-Wave Elastography for the Preoperative Risk Stratification of Follicular-patterned Lesions of the Thyroid: Diagnostic Accuracy and Optimal Measurement Plane. , 2015, Radiology.

[115]  F. Biancari,et al.  Prospective evaluation of multiparametric ultrasound and quantitative elastosonography in the differential diagnosis of benign and malignant thyroid nodules: preliminary experience. , 2012, European journal of radiology.

[116]  C. Catalano,et al.  Strain ratio ultrasound elastography increases the accuracy of colour-Doppler ultrasound in the evaluation of Thy-3 nodules. A bi-centre university experience , 2016, European Radiology.

[117]  B. Dwamena,et al.  Comparative effectiveness of elastographic and B-mode ultrasound criteria for diagnostic discrimination of thyroid nodules: a meta-analysis. , 2013, AJR. American journal of roentgenology.

[118]  Eva Herrmann,et al.  Acoustic Radiation Force Impulse Imaging for Differentiation of Thyroid Nodules , 2012, PloS one.

[119]  Fengkui Fu,et al.  Assessment of Diffuse Thyroid Disease by Strain Ratio in Ultrasound Elastography. , 2015, Ultrasound in medicine & biology.

[120]  T. Fahey,et al.  Is Elastography Actually Useful in the Presurgical Selection of Thyroid Nodules with Indeterminate Cytology , 2012 .

[121]  M. Castellano,et al.  Elastography Evaluation of Benign Thyroid Nodules in Patients Affected by Hashimoto's Thyroiditis , 2015, International journal of endocrinology.

[122]  Ming-de Lu,et al.  Two-dimensional shear wave elastography as promising diagnostic tool for predicting malignant thyroid nodules: a prospective single-centre experience , 2015, European Radiology.

[123]  F. Consorti,et al.  Prospective comparative evaluation of quantitative-elastosonography (Q-elastography) and contrast-enhanced ultrasound for the evaluation of thyroid nodules: preliminary experience. , 2013, European journal of radiology.

[124]  A. Pinchera,et al.  Real-time elastosonography: useful tool for refining the presurgical diagnosis in thyroid nodules with indeterminate or nondiagnostic cytology. , 2010, The Journal of clinical endocrinology and metabolism.