Virtual Touch Tissue Imaging Quantification In Differential Diagnosis Of Benign And Malignant TI-RADS 4 Thyroid Nodules?0.6cm

Objective:To observe the value of virtual touch tissue imaging quantification(VTIQ)in differential diagnosis of thyroid imaging reporting and data system(TI-RADS)4 thyroid nodules ? 0.6cm.Methods:Two group of TI-RADS 4 thyroid nodules will be surgical resected over the same period were included in this study.The nodules were divided into two groups according to the maximum size as follows:the study group,the maximum size? 0.6cm,93 patients 97 nodules;control group,the maximum size>1cm,51 patients 51 nodules.Multi zone sampling measurement were done by VTIQ for each nodules before the operation,a number of shear wave velocity(SWV)data were obtained,the maximum value(SWVmax)and the average value(SWVmean)as the hardness parameter of nodules respectively.Postoperative pathology results as the gold standard,the hardness parameter with best diagnostic efficiency was found out by drawn receiver operating characteristic(ROC)of the study group and compared with the control group.The hardness difference of nodules with different sizes was studied.The cut-off value of the study group was found according to the hardness parameter and the diagnostic efficiency was assessed lastly.Results:?SWVmean as the hardness parameter,area under the curve of ROC(AUC)was 0.892.SWVmax as the hardness parameter,AUC was 0.787.The difference of them was statistically significant by Z test(P<0.01).SWVmean as the hardness parameter to differential diagnose benign and malignant nodules of the study group was superior to SWVmax.?SWVmean of malignant nodules in two groups was greater than benign nodules and the difference was statistically significant(P<0.01).SWVmean of the malignant nodules in control group was greater than the study group,the difference was statistically significant(P<0.05).There was no significant difference in SWVmean between the two groups of benign nodules(P>0.05).?SWVmean as the hardness parameters to differential diagnose benign and malignant of the study group?control group by VTIQ,the cut-off values were 2.44m/s,2.49m/s,the diagnostic sensitivity was 79%,88.6%,the specificity was 88.6%,93.7%,the accuracy was 83.5%,90.1%respectively and the Youden index were 0.68,0.82.Conclusions:?The application of VTIQ in the differential diagnosis of benign and malignant TI-RADS 4 thyroid nodules?0.6cm has a certain value,SWVmean as the hardness parameter to differential diagnose is superior to SWVmax.?SWVmean as the hardness parameters,the efficiency of the differential diagnosis of benign and malignant TI-RADS 4 thyroid nodules by VTIQ was related to the size of nodules:the nodules of the maximum size ?0.6cm lower than the nodules of the maximum size>1cm.