Impact of Region-of-Interest Size on the Diagnostic Performance of Shear Wave Elastography in Differentiating Thyroid Nodules

SIMPLE SUMMARY: In our pursuit for accurate thyroid nodule diagnosis, a common challenge, this study was conducted to investigate the role of shear wave elastography (SWE). Specifically, we examined the influence of the selection of different regions of interest (ROIs) on the diagnostic effectiveness of SWE. By employing three ROI sizes (1 mm, 2 mm, and Max), we found that although SWE is generally effective in distinguishing between malignant and benign nodules, the choice of ROI size can significantly influence the diagnostic accuracy of specific SWE elasticity metrics. Our study not only enhances the current understanding of SWE’s utility in thyroid nodule assessment but also offers valuable insights for future research, potentially paving the way for more reliable diagnostic techniques. ABSTRACT: This study investigated the impact of different region-of-interest (ROI) sizes (Max, 1 mm, and 2 mm) on shear wave elastography (SWE) in differentiating between malignant and benign thyroid nodules. The study cohort comprised 129 thyroid nodules (50 malignant, 79 benign) and 78 normal subjects. Diagnostic efficacy was assessed through pairwise comparisons of area under the curve (AUC) values in receiver operating characteristic analysis by using DeLong’s test. Our results indicated significant differences in all SWE elasticity metrics between the groups, with malignant nodules exhibiting higher values than benign nodules (p < 0.05). Smaller ROIs (1 and 2 mm) were found to outperform the max ROI in terms of diagnostic accuracy, particularly for the E(max) and E(min) elasticity metrics. E(max()(1mm)) had the highest diagnostic accuracy, with an AUC of 0.883, sensitivity of 74.0%, and specificity of 86.1%. This study underscores the significant influence of ROI size selection on the diagnostic performance of SWE, offering valuable insights for future research and clinical applications in thyroid nodule assessment.