Elastography in patients with thyroid nodule for the detection of malignancy: a systematic review from 2020 to the present.

Abstract

Introduction. Thyroid nodules are a common pathology, although the malignancy rate is low. Diagnosis of malignancy in these nodules usually requires invasive methods such as fine needle aspiration (FNA), which can be expensive and have limitations. Thyroid elastography, a noninvasive technique that assesses tissue elasticity, has emerged as a promising alternative. Methodology. This study reviews the literature on the sensitivity and specificity of elastography for the detection of malignancy in thyroid nodules, comparing it with conventional methods, through a systematic search of studies published since 2020. From a total of 592 articles reviewed, 27 studies that met the inclusion criteria were selected. Results. These indicate that elastography has a sensitivity greater than 50% and a specificity greater than 49%, with studies such as that of Rajabzadeh et al. (2023) achieving 100% in both parameters with a specific kPa value. Most studies used post-surgical histology as the reference standard. Although high variability in methods was observed, the predominant use of quantitative elastography (Shear Wave) and the growing evidence of its effectiveness highlight its potential in the evaluation of thyroid nodules. Conclusions and recommendations. Further research and standardization of protocols is recommended to improve the accuracy and applicability of this technique, in order to reduce unnecessary invasive procedures and improve early detection of thyroid cancer.