Advances in imaging techniques for thyroid disease: ultrasound, elastography, and beyond – A prospective observational cross-sectional study.

Shikhar  Saxena; Parul  Sachan; Daya  Shankar; Rohini  Srivastava

doi:10.51168/sjhrafrica.v7i2.2656

Authors

Shikhar Saxena Associate Professor, Department of ENT, Naraina Medical College and Research Centre, Gangaganj, Panki Kanpur, Uttar Pradesh, India.
Parul Sachan Assistant Professor, Department of Pathology, Maa Vindhyavasini Autonomous State Medical College, Mirzapur, Uttar Pradeesh, India.
Daya Shankar Associate Professor, Department of Otorhinolaryngology, KMC Medical College and Hospital Maharajganj, Uttar Pradesh, India
Rohini Srivastava Associate Professor, Department of Pathology, Naraina Medical College and Research Centre, Kanpur, Uttar Pradesh, India

DOI:

https://doi.org/10.51168/sjhrafrica.v7i2.2656

Keywords:

Thyroid nodules, ultrasonography, elastography, diagnostic imaging, thyroid cancer, FNAC

Abstract

Background

Accurate differentiation of benign and malignant thyroid nodules is essential for appropriate management and early detection of thyroid cancer. While ultrasonography (USG) is the primary imaging modality for thyroid evaluation, its specificity is limited by overlapping features between benign and malignant lesions. Elastography and other advanced imaging techniques have emerged as valuable adjuncts to improve diagnostic accuracy.

Methods

This prospective observational cross-sectional study included 110 adult patients with suspected thyroid disease over 11 months. All participants underwent conventional ultrasonography and elastography, while selected cases received advanced imaging, including contrast-enhanced ultrasonography and Doppler vascularity assessment. Imaging findings were correlated with fine-needle aspiration cytology (FNAC) and histopathological examination. Diagnostic performance was assessed using sensitivity, specificity, accuracy, and Chi-square testing, with p<0.05 considered statistically significant.

Results

Among the 110 patients, 78 (70.9%) had benign lesions, and 32 (29.1%) had malignant lesions. Ultrasonography demonstrated a sensitivity of 85.2%, specificity of 72.5%, and accuracy of 78.9%. Elastography showed superior performance with a sensitivity of 90.6%, specificity of 84.3%, and accuracy of 87.3%. The combined use of ultrasonography and elastography achieved the highest diagnostic accuracy (90.9%) and showed a statistically significant improvement compared with individual modalities (p=0.008). Elastography scores of 4–5 were significantly associated with malignancy (p=0.001). Hypoechogenicity, microcalcifications, and irregular margins were also significantly associated with malignant lesions.

Conclusion

Elastography significantly enhances the diagnostic performance of conventional ultrasonography. A multimodal imaging approach improves diagnostic accuracy and may reduce unnecessary invasive procedures.

Recommendation

Routine incorporation of elastography alongside conventional ultrasonography is recommended for comprehensive evaluation of thyroid nodules and improved early detection of thyroid malignancy.

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