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Figure 1.

B-mode ultrasound of the right lobe of thyroid gland using the S2000, 9L4 probe at 9 MHz with the ROI placed within the healthy thyroid tissue measuring an ARFI velocity of 1.90 m/s.

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Figure 2.

Acoustic Radiation Force Impulse Imaging (S2000, 9L4 probe at 9 MHz) of the same patient a in

Figure 1 with the ROI placed within a hypoechoic thyroid nodule in the right thyroid lobe measuring a velocity of 6.24 m/s. Histology revealed papillary carcinoma.

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Table 1.

Patient characteristics.

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Table 2.

Senstivity, specificity, PPV and NPV for thyroid cancer for different ultrasound patterns (including RTE and ARFI) in thyroid nodules.

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Table 3.

ARFI velocity characteristics.

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Table 3 Expand

Figure 3.

Receiver-operating characteristic (ROC) curves for ARFI-imaging of thyroid nodule (ARFI-nod) and for the ratio of ARFI-imaging of thyroid nodule divided by ARFI-imaging of healthy thyroid tissue (ARFI-rat) for diagnosis of malignant thyroid nodules (AUROC 69% and 71%, respectively) and the ROC curves for the combination of these criteria with Realtime Elastography Score (ES) 3–4 (AUROC 78% and 78%, respectively).

The improvements with respect to ARFI alone were not significant (p = 0.18 for ARFI-nod, p>0.20 for ARFI-rat), analogously the improvements with respect to ES alone were not significant (p>0.20 in both cases).

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Figure 3 Expand