Can preoperative ultrasound elastography predict aggressive features of solitary papillary thyroid carcinoma?

Objective: To investigate whether preoperative ultrasound elastography (USE) can be used to predict aggressive features of solitary papillary thyroid carcinomas (PTCs). Methods: Clinical and USE indices were retrospectively analyzed in 487 patients with surgically confirmed solitary PTCs. The patients were grouped per aggressive features on pathologic testing. Univariate and binary logistic regression analyses were performed to explore independent risk factors of aggressive features. Results: Univariate analysis revealed standard deviation (SD) values of the tumor shearwave velocity (SWV) were associated with capsular invasion (p < 0.05). Further, shearwave elasticity and SWV ratios correlated with extrathyroidal extension (all p < 0.05). The tumor shearwave elasticity and SWV SD values were associated with cervical lymph node metastasis (CLNM) (all p < 0.05). Binary logistic regression analysis identified location and capsule contact as independent predictive risk factors for capsular invasion (all p < 0.05); size for extrathyroidal extension (all p < 0.05); and sex, age, margin, and suspected CLNM for CLNM (all p < 0.05). However, preoperational USE indexes were not independent predictors of aggressive features (all p > 0.05). Conclusion: Pre- operative USE indices were not independent risk factors of aggressive features of solitary PTCs. Thus, USE may have a limited value for predicting the aggressive features of PTC. Advances in knowledge: Pre- operative USE indices may have a limited value for predicting the aggressive features of PTC.