Guidelines and recommendations on the clinical use of shear wave elastography for evaluating thyroid nodule¹

Article type: Research Article

Authors: Xu, Hui-Xiong^{a; b; c; 2; *} | Yan, Kun^{d; 2; *} | Liu, Bo-Ji^{a; b; c; 2} | Liu, Wen-Ying^{d; 2} | Tang, Li-Na^e | Zhou, Qi^f | Wu, Jin-Yu^g | Xue, En-Sheng^h | Shen, Binⁱ | Tang, Qing^j | Chen, Qin^k | Xue, Hong-Yuan^l | Li, Ying-Jia^m | Guo, Junⁿ | Wang, Bin^o | Li, Fang^p | Yan, Chun-Yang^q | Li, Quan-Shui^r | Wang, Yan-Qing^s | Zhang, Wei^t | Wu, Chang-Jun^u | Yu, Wen-Hui^v | Zhou, Su-Jin^w

Affiliations: [a] Department of Medical Ultrasound, Shanghai Tenth People’s Hospital, Ultrasound Research and Education Institute, Tongji University School of Medicine, Shanghai, China | [b] Thyroid Institute, Tongji University School of Medicine, Shanghai, China | [c] Shanghai Center for Thyroid Diseases, Shanghai, China | [d] Department of Ultrasound, Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Peking University Cancer Hospital & Institute, Beijing, China | [e] Department of Ultrasound, Fujian Cancer Hospital & Fujian Medical University Cancer Hospital, Fuzhou, China | [f] Department of Ultrasound, Second Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China | [g] Department of Ultrasound, Harbin First Hospital, Harbin, China | [h] Department of Ultrasound, Union Hospital, Fujian Medical University, Fuzhou, China | [i] Department of Ultrasound, People’s Hospital of Fenghua, Fenghua, China | [j] Department of Ultrasound, First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China | [k] Department of Ultrasound, Sichuan Provincial People’s Hospital, Chengdu, China | [l] Department of Ultrasound, Hebei General Hospital, Shijiazhuang, China | [m] Department of Ultrasound, Nanfang Hospital, Southern Medical University, Guangzhou, China | [n] Department of Ultrasound, Peking University Aerospace School of Clinical Medicine, Beijing, China | [o] Department of Ultrasound, Peking University First Hospital, Beijing, China | [p] Department of Ultrasound, Chongqing Cancer Hospital, Chongqing, China | [q] Department of Ultrasound, Seventh People’s Hospital of Ningbo, Ningbo, China | [r] Department of Ultrasound, Luohu Hospital Group Affiliated to Shenzhen University, Shenzhen, China | [s] Department of Ultrasound, Zhengzhou People’s Hospital, Zhengzhou, China | [t] Department of Ultrasound, The Third Affiliated Hospital of Guangxi Medical University, Nanning, China | [u] Department of Ultrasound, First Affiliated Hospital of Harbin Medical University, Harbin, China | [v] Department of Ultrasound, Wuchang Hospital of Hubei Province, Wuhan, China | [w] Department of Ultrasound, Guangdong Second Provincial General Hospital, Guangzhou, China

Correspondence: [*] Corresponding authors. Hui-Xiong Xu, Department of Medical Ultrasound, Shanghai Tenth People’s Hospital, Ultrasound Research and Education Institute, Tongji University School of Medicine, 301 Yangchangzhong Rd, Shanghai 200072, China. Tel.: +86 21 66307539; Fax: +86 21 66301031 (O); E-mail: xuhuixiong@126.com and Kun Yan, Department of Ultrasound, Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Peking University Cancer Hospital & Institute, Beijing, China. Tel.: +86 10 88196910; E-mail: ydbz@vip.sina.com.

Note: [1] On behalf of the Task Force of Thyroid Elastography Expert Group, Society of Ultrasound in Medicine, Chinese Medical Association.

Note: [2] These authors contributed equally to the article.

Abstract: Ultrasound elastography has been introduced into clinical practice for a decade and arisen continuous increasing attention worldwide. Shear wave elastography (SWE) is a further extension of ultrasound elastography on the basis of strain elastography, providing a two-dimensional distribution map of tissue stiffness and quantitative measurement of the tissue stiffness in Young’s modulus (kPa) and/or shear wave speed (m/s). The Society of Ultrasound in Medicine, Chinese Medical Association (CMA) has recently released a series of guidelines for the use of SWE, including the technique and principle of SWE, and use of SWE in liver fibrosis, breast, thyroid, and musculoskeletal system. Herein, a part of SWE in thyroid nodules is presented. In this guideline, the background, classification and technology of SWE, examination methods, diagnostic performance, prognosis evaluation, reproducibility, and limitations are discussed and recommendations are given. The recommendations are based on the published literatures with regard to SWE with different levels of evidence, particularly a mid-term result of the prospective multi-center clinical trial of SWE in thyroid, as well as the Society of Ultrasound in Medicine, CMA expert’s consensus. The document provides an overall analysis of SWE in thyroid from clinical perspective, which aimed to provide recommendations to the clinicians with regard to the management of thyroid nodules by the assistance of SWE.

Keywords: Thyroid, ultrasound, shear wave elastography, elastography, guideline

DOI: 10.3233/CH-180452

Journal: Clinical Hemorheology and Microcirculation, vol. 72, no. 1, pp. 39-60, 2019