First trial with thyroid elastograhy (ECI) shows promising results

A preliminary study for thyroid examination with the new Accuvix A30 from Samsung has shown positive results. Dr Vito Cantisani, PhD, Radiologist at the hospital Umberto I from university Sapienza in Rome, president of CEUS and New Application section of SIUMB, presented the first preliminary results with thyroid elastography ECI at ECR 2012.

Photo: First trial with thyroid elastograhy (ECI) shows promising results
Vito Cantisani
Vito Cantisani

He said: “The preliminary study with Accuvix A30 for thyroid examinations earlier this year shows promising results.” He performed the first trial of the new technology before Samsung introduced Accuvix A30 to the European market at ECR 2012.

“Accuvix A30 for thyroid examinations showed good accuracy in the characterization of thyroid nodules, significantly more accurate than color-doppler-US alone,” Dr Cantisani explains. Additional advantages are that it is easy to use, does not need compression and it allows a reduction of false positives and negatives. For the study, all patients were examined with normal ultrasound, doppler ultrasound and elastography by elastoscan.

The Italian radiologist examined together with two other colleagues, the efficiency and accuracy of ECI (Elastoscan Core Index) in the differentiation of lesions. “We assessed the feasibility, the accuracy, and the interobserver variability as well. I and two of my colleagues with different levels of experience explored the same patients one day before surgery.”

Before starting the trial Dr Cantisani evaluated the best technique for using the application. He tested if it was better to use the axial or the longitudinal scanning. After choosen the best plane the Elastoscan allowed to calculate the ECI, the difference of the elasticity between the thyroid and the nodule. Dr Cantisani said that the higher the ECI, the higher the likelihood was of a malignant tumor. The analysis of the data showed that the best technique is the axial scanning of the patient’s neck, which must stop breathing for a few seconds while resting calm.

During this process the radiologist uses the effect of the pulsation of the common carotid artery, to determine the elasticity of the thyroid and nodule and that is shown in a polychromic map. The specificity and the sensitivity of the lesions corresponded well with the histological results and better still with the results of common echography. The comparison between the observers showed a fair to good concordance, thus reducing the interobserver variability, which is until now a great limitation of any elastographic techniques.

“We are looking forward to receiving Accuvix A30 again for more time in our hospital to extend the patient population to acquire more reliable results and with the novel technology and compare the results with those of other studies.

“After a short training period, elastoscan imporoves the accuracy of basic ultrasound examination. The goal of the use of this kind of technique is moreover to reduce the number of FNA (fine needle aspiration) and increase the confidence of the Radiologists’ diagnosis,” Dr Cantisani concludes. By Brigitte Dinkloh.



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