ESPE Abstracts (2015) 84 P-1-164

Practical Application of Elastography in the Diagnosis of Thyroid Nodules in Children

Hanna Borysewicz-Sanczyka, Beata Sawickaa, Janusz Dzieciolb, Katarzyna Drzewekc, Magdalena Oleksinskac, Klaudyna Noiszewskaa & Artur Bossowskic


aDepartment of Pediatrics, Endocrinology and Diabetes with Cardiology Division, Medical University of Bialystok, Bialystok, Poland; bDepartment of Human Anatomy, Medical University of Bialystok, Bialystok, Poland; cStudents’ Scientific Association at the Department of Pediatrics, Endocrinology, and Diabetology with Cardiology Division, Medical University of Bialystok, Bialystok, Poland


Background: Elastography is non-invasive ultrasound method of imaging based on estimation of mechanical properties (elasticity) of the tissue. Recent data has shown its ability to differentiate benign from malignant tumours. Decreased flexibility in comparison to around tissue is characteristic for malignant tissues, like most thyroid carcinoma (except follicular thyroid carcinoma). Analysis of the image gives the result presented as a ROI1/ROI2 index.

Objective and hypotheses: The purpose of our study was to assess the deformation of the thyroid nodules during elastography in comparision to the results of fine needle aspiration cytology of the nodule.

Method: We examined 47 children between February 2013 and February 2015 with nodular goiter. All patients underwent elastography and fine needle aspiration cytology (FNAC). Both data were compared in order to determine any correlations. Elastography parameters were acquired with Toshiba Aplio MX SSA-780A system and analysed while comparing of the stiffness of ROI 1 (of the nodule) to ROI 2 (of healthy tissue).

Results: In the study 39 girls (83%) and 8 boys (17%) were involved. ROI index below two was observed in nine patients (19.2% of the study group). In 27 patients (57.4% of the study group) ROI1/ROI2 was between two and 4.9. ROI index above five was observed in 11 patients (23.4% of the study group). In three patients (6.4% of patients) histopathological examination confirmed thyroid carcinoma. In all of cases it was papillary thyroid carcinoma. ROI index: five and above was present in two patients with thyroid cancer, while one of the patients had ROI index two.

Conclusion: Our results suggest, that elastography can be complementary to classic ultrasonography and useful while taking decision about fine needle aspiration cytology. At the same time it should not replace histopathological assessment of the nodule in the thyroid.

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