Low Elasticity of Thyroid Nodules on Ultrasound Elastography Is Correlated with Malignancy, Degree of Fibrosis, and High Expression of Galectin-3 and Fibronectin-1
Background: Thyroid ultrasound (US) elastography provides an estimation of tissue stiffness and is helpful to differentiate malignant from benign lesions. Tissue proprieties and molecules causing stiffness are not established. The aim of the study was to correlate US elastography findings with tissu...
Gespeichert in:
| Veröffentlicht in: | Thyroid (New York, N.Y.) N.Y.), 2017-01, Vol.27 (1), p.13-110 |
|---|---|
| Hauptverfasser: | , , , , , , , , , , , , , |
| Format: | Artikel |
| Sprache: | eng |
| Schlagworte: | |
| Online-Zugang: | Volltext |
| Tags: |
Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
|
| container_end_page | 110 |
|---|---|
| container_issue | 1 |
| container_start_page | 13 |
| container_title | Thyroid (New York, N.Y.) |
| container_volume | 27 |
| creator | Rago, Teresa Scutari, Maria Loiacono, Valeria Santini, Ferruccio Tonacchera, Massimo Torregrossa, Liborio Giannini, Riccardo Borrelli, Nicla Proietti, Agnese Basolo, Fulvio Miccoli, Paolo Piaggi, Paolo Latrofa, Francesco Vitti, Paolo |
| description | Background:
Thyroid ultrasound (US) elastography provides an estimation of tissue stiffness and is helpful to differentiate malignant from benign lesions. Tissue proprieties and molecules causing stiffness are not established. The aim of the study was to correlate US elastography findings with tissue properties in thyroid nodules.
Methods:
A total of 115 thyroid nodules from 112 patients who underwent surgery for the presence of Thy 3 (indeterminate) cytology (
n
= 67), Thy 4–5 (suspicious—indicative of carcinoma) cytology (
n
= 47), or large goiter in the presence of Thy 2 cytology (
n
= 1) and suspicious US features were examined by US elastography. Tissues obtained after surgery were characterized for cell number, microvessel density, fibrosis, and expression of galectin-3 (Gal-3) and fibronectin-1 (FN-1).
Results:
Low elasticity on qualitative US elastography (LoEl) was found in 66 nodules (one benign and 65 carcinomas); high elasticity (HiEl) was found in 49 nodules (46 benign and three carcinomas;
p
|
| doi_str_mv | 10.1089/thy.2016.0341 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_1836731346</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>1836731346</sourcerecordid><originalsourceid>FETCH-LOGICAL-c376t-b41eac370889fcd41e04a29d1c336bc2161c8f822c04e4ec107f6f9e6e27b6d83</originalsourceid><addsrcrecordid>eNqFkctu3CAUQFHVqHm0y24rll3EEzAewMtqOnlI02STrC2Mr8dUDEwBK_X39EeL46TbrrhcHR3p6iD0mZIVJbK-SsO0KgnlK8Iq-g6d0fVaFDUR4n2eyZoUolzzU3Qe40-SMSnYB3RaCklqXldn6M_OP-OtVTEZbdKEfY8fhyl40-F7340WIvYOP9kUVPSj6xbW74M6DhO-i3jjQwCrEnT42aQB_1DW7J1yerrE32EfAGbntWmDjyZeYpUdt2Y_4O3vY4AYTdZn4EZZ0Mm4gr0QL7xbNvQjOumVjfDp9b1AT9fbx81tsXu4udt82xWaCZ6KtqKg8kikrHvd5R-pVFl3VDPGW11STrXsZVlqUkEFmhLR874GDqVoeSfZBfq6eI_B_xohpuZgogZrlQM_xoZKxgWjrOIZLRZU57NigL45BnNQYWooaeYuTe7SzF2auUvmv7yqx_YA3T_6LUQG2ALMa-WcNdBCSP_R_gW4M5xF</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1836731346</pqid></control><display><type>article</type><title>Low Elasticity of Thyroid Nodules on Ultrasound Elastography Is Correlated with Malignancy, Degree of Fibrosis, and High Expression of Galectin-3 and Fibronectin-1</title><source>MEDLINE</source><source>Alma/SFX Local Collection</source><creator>Rago, Teresa ; Scutari, Maria ; Loiacono, Valeria ; Santini, Ferruccio ; Tonacchera, Massimo ; Torregrossa, Liborio ; Giannini, Riccardo ; Borrelli, Nicla ; Proietti, Agnese ; Basolo, Fulvio ; Miccoli, Paolo ; Piaggi, Paolo ; Latrofa, Francesco ; Vitti, Paolo</creator><creatorcontrib>Rago, Teresa ; Scutari, Maria ; Loiacono, Valeria ; Santini, Ferruccio ; Tonacchera, Massimo ; Torregrossa, Liborio ; Giannini, Riccardo ; Borrelli, Nicla ; Proietti, Agnese ; Basolo, Fulvio ; Miccoli, Paolo ; Piaggi, Paolo ; Latrofa, Francesco ; Vitti, Paolo</creatorcontrib><description>Background:
Thyroid ultrasound (US) elastography provides an estimation of tissue stiffness and is helpful to differentiate malignant from benign lesions. Tissue proprieties and molecules causing stiffness are not established. The aim of the study was to correlate US elastography findings with tissue properties in thyroid nodules.
Methods:
A total of 115 thyroid nodules from 112 patients who underwent surgery for the presence of Thy 3 (indeterminate) cytology (
n
= 67), Thy 4–5 (suspicious—indicative of carcinoma) cytology (
n
= 47), or large goiter in the presence of Thy 2 cytology (
n
= 1) and suspicious US features were examined by US elastography. Tissues obtained after surgery were characterized for cell number, microvessel density, fibrosis, and expression of galectin-3 (Gal-3) and fibronectin-1 (FN-1).
Results:
Low elasticity on qualitative US elastography (LoEl) was found in 66 nodules (one benign and 65 carcinomas); high elasticity (HiEl) was found in 49 nodules (46 benign and three carcinomas;
p
< 0.0001). Quantitative analysis, performed in 24 nodules and expressed as elastic ratio between the strain of the nodule and that of the surrounding thyroid parenchyma, showed a mean of 1.90 (interquartile range [IQR] 1.18–2.77) in 14 nodules with LoEl, and a mean of 1.01 (IQR 0.91–1.10) in 10 nodules with HiEl (
p
= 0.002). Stiffness did not correlate with cell number and was inversely correlated with microvessel density. Fibrosis was higher in nodules with LoEl than in those with HiEl (
p
= 0.009) and in carcinomas than in benign nodules (
p
= 0.02). Fibrosis was higher in nodules with high expression of Gal-3 (
p
< 0.001) and FN-1 (
p
= 0.004). Fibrosis and expression of Gal-3 and FN-1 were higher in the classic compared with the follicular variant of papillary thyroid carcinoma and lower in follicular adenomas.
Conclusions:
Low elasticity at US elastography is highly correlated with malignancy. Nodule stiffness is correlated with fibrosis and expression of Gal-3 and FN-1. These features are more evident in the classic than in the follicular variant of papillary thyroid carcinoma.</description><identifier>ISSN: 1050-7256</identifier><identifier>EISSN: 1557-9077</identifier><identifier>DOI: 10.1089/thy.2016.0341</identifier><identifier>PMID: 27809694</identifier><language>eng</language><publisher>United States: Mary Ann Liebert, Inc</publisher><subject>Adenoma - diagnostic imaging ; Adenoma - metabolism ; Adenoma - pathology ; Adult ; Carcinoma - diagnostic imaging ; Carcinoma - metabolism ; Carcinoma - pathology ; Diagnosis, Differential ; Elasticity ; Elasticity Imaging Techniques ; Female ; Fibronectins - metabolism ; Fibrosis - diagnostic imaging ; Fibrosis - metabolism ; Fibrosis - pathology ; Galectin 3 - metabolism ; Humans ; Male ; Middle Aged ; Thyroid Neoplasms - diagnostic imaging ; Thyroid Neoplasms - metabolism ; Thyroid Neoplasms - pathology ; Thyroid Nodule - diagnostic imaging ; Thyroid Nodule - metabolism ; Thyroid Nodule - pathology ; Thyroid Radiology and Nuclear Medicine</subject><ispartof>Thyroid (New York, N.Y.), 2017-01, Vol.27 (1), p.13-110</ispartof><rights>2017, Mary Ann Liebert, Inc.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c376t-b41eac370889fcd41e04a29d1c336bc2161c8f822c04e4ec107f6f9e6e27b6d83</citedby><cites>FETCH-LOGICAL-c376t-b41eac370889fcd41e04a29d1c336bc2161c8f822c04e4ec107f6f9e6e27b6d83</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/27809694$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Rago, Teresa</creatorcontrib><creatorcontrib>Scutari, Maria</creatorcontrib><creatorcontrib>Loiacono, Valeria</creatorcontrib><creatorcontrib>Santini, Ferruccio</creatorcontrib><creatorcontrib>Tonacchera, Massimo</creatorcontrib><creatorcontrib>Torregrossa, Liborio</creatorcontrib><creatorcontrib>Giannini, Riccardo</creatorcontrib><creatorcontrib>Borrelli, Nicla</creatorcontrib><creatorcontrib>Proietti, Agnese</creatorcontrib><creatorcontrib>Basolo, Fulvio</creatorcontrib><creatorcontrib>Miccoli, Paolo</creatorcontrib><creatorcontrib>Piaggi, Paolo</creatorcontrib><creatorcontrib>Latrofa, Francesco</creatorcontrib><creatorcontrib>Vitti, Paolo</creatorcontrib><title>Low Elasticity of Thyroid Nodules on Ultrasound Elastography Is Correlated with Malignancy, Degree of Fibrosis, and High Expression of Galectin-3 and Fibronectin-1</title><title>Thyroid (New York, N.Y.)</title><addtitle>Thyroid</addtitle><description>Background:
Thyroid ultrasound (US) elastography provides an estimation of tissue stiffness and is helpful to differentiate malignant from benign lesions. Tissue proprieties and molecules causing stiffness are not established. The aim of the study was to correlate US elastography findings with tissue properties in thyroid nodules.
Methods:
A total of 115 thyroid nodules from 112 patients who underwent surgery for the presence of Thy 3 (indeterminate) cytology (
n
= 67), Thy 4–5 (suspicious—indicative of carcinoma) cytology (
n
= 47), or large goiter in the presence of Thy 2 cytology (
n
= 1) and suspicious US features were examined by US elastography. Tissues obtained after surgery were characterized for cell number, microvessel density, fibrosis, and expression of galectin-3 (Gal-3) and fibronectin-1 (FN-1).
Results:
Low elasticity on qualitative US elastography (LoEl) was found in 66 nodules (one benign and 65 carcinomas); high elasticity (HiEl) was found in 49 nodules (46 benign and three carcinomas;
p
< 0.0001). Quantitative analysis, performed in 24 nodules and expressed as elastic ratio between the strain of the nodule and that of the surrounding thyroid parenchyma, showed a mean of 1.90 (interquartile range [IQR] 1.18–2.77) in 14 nodules with LoEl, and a mean of 1.01 (IQR 0.91–1.10) in 10 nodules with HiEl (
p
= 0.002). Stiffness did not correlate with cell number and was inversely correlated with microvessel density. Fibrosis was higher in nodules with LoEl than in those with HiEl (
p
= 0.009) and in carcinomas than in benign nodules (
p
= 0.02). Fibrosis was higher in nodules with high expression of Gal-3 (
p
< 0.001) and FN-1 (
p
= 0.004). Fibrosis and expression of Gal-3 and FN-1 were higher in the classic compared with the follicular variant of papillary thyroid carcinoma and lower in follicular adenomas.
Conclusions:
Low elasticity at US elastography is highly correlated with malignancy. Nodule stiffness is correlated with fibrosis and expression of Gal-3 and FN-1. These features are more evident in the classic than in the follicular variant of papillary thyroid carcinoma.</description><subject>Adenoma - diagnostic imaging</subject><subject>Adenoma - metabolism</subject><subject>Adenoma - pathology</subject><subject>Adult</subject><subject>Carcinoma - diagnostic imaging</subject><subject>Carcinoma - metabolism</subject><subject>Carcinoma - pathology</subject><subject>Diagnosis, Differential</subject><subject>Elasticity</subject><subject>Elasticity Imaging Techniques</subject><subject>Female</subject><subject>Fibronectins - metabolism</subject><subject>Fibrosis - diagnostic imaging</subject><subject>Fibrosis - metabolism</subject><subject>Fibrosis - pathology</subject><subject>Galectin 3 - metabolism</subject><subject>Humans</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Thyroid Neoplasms - diagnostic imaging</subject><subject>Thyroid Neoplasms - metabolism</subject><subject>Thyroid Neoplasms - pathology</subject><subject>Thyroid Nodule - diagnostic imaging</subject><subject>Thyroid Nodule - metabolism</subject><subject>Thyroid Nodule - pathology</subject><subject>Thyroid Radiology and Nuclear Medicine</subject><issn>1050-7256</issn><issn>1557-9077</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2017</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFkctu3CAUQFHVqHm0y24rll3EEzAewMtqOnlI02STrC2Mr8dUDEwBK_X39EeL46TbrrhcHR3p6iD0mZIVJbK-SsO0KgnlK8Iq-g6d0fVaFDUR4n2eyZoUolzzU3Qe40-SMSnYB3RaCklqXldn6M_OP-OtVTEZbdKEfY8fhyl40-F7340WIvYOP9kUVPSj6xbW74M6DhO-i3jjQwCrEnT42aQB_1DW7J1yerrE32EfAGbntWmDjyZeYpUdt2Y_4O3vY4AYTdZn4EZZ0Mm4gr0QL7xbNvQjOumVjfDp9b1AT9fbx81tsXu4udt82xWaCZ6KtqKg8kikrHvd5R-pVFl3VDPGW11STrXsZVlqUkEFmhLR874GDqVoeSfZBfq6eI_B_xohpuZgogZrlQM_xoZKxgWjrOIZLRZU57NigL45BnNQYWooaeYuTe7SzF2auUvmv7yqx_YA3T_6LUQG2ALMa-WcNdBCSP_R_gW4M5xF</recordid><startdate>20170101</startdate><enddate>20170101</enddate><creator>Rago, Teresa</creator><creator>Scutari, Maria</creator><creator>Loiacono, Valeria</creator><creator>Santini, Ferruccio</creator><creator>Tonacchera, Massimo</creator><creator>Torregrossa, Liborio</creator><creator>Giannini, Riccardo</creator><creator>Borrelli, Nicla</creator><creator>Proietti, Agnese</creator><creator>Basolo, Fulvio</creator><creator>Miccoli, Paolo</creator><creator>Piaggi, Paolo</creator><creator>Latrofa, Francesco</creator><creator>Vitti, Paolo</creator><general>Mary Ann Liebert, Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20170101</creationdate><title>Low Elasticity of Thyroid Nodules on Ultrasound Elastography Is Correlated with Malignancy, Degree of Fibrosis, and High Expression of Galectin-3 and Fibronectin-1</title><author>Rago, Teresa ; Scutari, Maria ; Loiacono, Valeria ; Santini, Ferruccio ; Tonacchera, Massimo ; Torregrossa, Liborio ; Giannini, Riccardo ; Borrelli, Nicla ; Proietti, Agnese ; Basolo, Fulvio ; Miccoli, Paolo ; Piaggi, Paolo ; Latrofa, Francesco ; Vitti, Paolo</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c376t-b41eac370889fcd41e04a29d1c336bc2161c8f822c04e4ec107f6f9e6e27b6d83</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2017</creationdate><topic>Adenoma - diagnostic imaging</topic><topic>Adenoma - metabolism</topic><topic>Adenoma - pathology</topic><topic>Adult</topic><topic>Carcinoma - diagnostic imaging</topic><topic>Carcinoma - metabolism</topic><topic>Carcinoma - pathology</topic><topic>Diagnosis, Differential</topic><topic>Elasticity</topic><topic>Elasticity Imaging Techniques</topic><topic>Female</topic><topic>Fibronectins - metabolism</topic><topic>Fibrosis - diagnostic imaging</topic><topic>Fibrosis - metabolism</topic><topic>Fibrosis - pathology</topic><topic>Galectin 3 - metabolism</topic><topic>Humans</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Thyroid Neoplasms - diagnostic imaging</topic><topic>Thyroid Neoplasms - metabolism</topic><topic>Thyroid Neoplasms - pathology</topic><topic>Thyroid Nodule - diagnostic imaging</topic><topic>Thyroid Nodule - metabolism</topic><topic>Thyroid Nodule - pathology</topic><topic>Thyroid Radiology and Nuclear Medicine</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Rago, Teresa</creatorcontrib><creatorcontrib>Scutari, Maria</creatorcontrib><creatorcontrib>Loiacono, Valeria</creatorcontrib><creatorcontrib>Santini, Ferruccio</creatorcontrib><creatorcontrib>Tonacchera, Massimo</creatorcontrib><creatorcontrib>Torregrossa, Liborio</creatorcontrib><creatorcontrib>Giannini, Riccardo</creatorcontrib><creatorcontrib>Borrelli, Nicla</creatorcontrib><creatorcontrib>Proietti, Agnese</creatorcontrib><creatorcontrib>Basolo, Fulvio</creatorcontrib><creatorcontrib>Miccoli, Paolo</creatorcontrib><creatorcontrib>Piaggi, Paolo</creatorcontrib><creatorcontrib>Latrofa, Francesco</creatorcontrib><creatorcontrib>Vitti, Paolo</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Thyroid (New York, N.Y.)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Rago, Teresa</au><au>Scutari, Maria</au><au>Loiacono, Valeria</au><au>Santini, Ferruccio</au><au>Tonacchera, Massimo</au><au>Torregrossa, Liborio</au><au>Giannini, Riccardo</au><au>Borrelli, Nicla</au><au>Proietti, Agnese</au><au>Basolo, Fulvio</au><au>Miccoli, Paolo</au><au>Piaggi, Paolo</au><au>Latrofa, Francesco</au><au>Vitti, Paolo</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Low Elasticity of Thyroid Nodules on Ultrasound Elastography Is Correlated with Malignancy, Degree of Fibrosis, and High Expression of Galectin-3 and Fibronectin-1</atitle><jtitle>Thyroid (New York, N.Y.)</jtitle><addtitle>Thyroid</addtitle><date>2017-01-01</date><risdate>2017</risdate><volume>27</volume><issue>1</issue><spage>13</spage><epage>110</epage><pages>13-110</pages><issn>1050-7256</issn><eissn>1557-9077</eissn><abstract>Background:
Thyroid ultrasound (US) elastography provides an estimation of tissue stiffness and is helpful to differentiate malignant from benign lesions. Tissue proprieties and molecules causing stiffness are not established. The aim of the study was to correlate US elastography findings with tissue properties in thyroid nodules.
Methods:
A total of 115 thyroid nodules from 112 patients who underwent surgery for the presence of Thy 3 (indeterminate) cytology (
n
= 67), Thy 4–5 (suspicious—indicative of carcinoma) cytology (
n
= 47), or large goiter in the presence of Thy 2 cytology (
n
= 1) and suspicious US features were examined by US elastography. Tissues obtained after surgery were characterized for cell number, microvessel density, fibrosis, and expression of galectin-3 (Gal-3) and fibronectin-1 (FN-1).
Results:
Low elasticity on qualitative US elastography (LoEl) was found in 66 nodules (one benign and 65 carcinomas); high elasticity (HiEl) was found in 49 nodules (46 benign and three carcinomas;
p
< 0.0001). Quantitative analysis, performed in 24 nodules and expressed as elastic ratio between the strain of the nodule and that of the surrounding thyroid parenchyma, showed a mean of 1.90 (interquartile range [IQR] 1.18–2.77) in 14 nodules with LoEl, and a mean of 1.01 (IQR 0.91–1.10) in 10 nodules with HiEl (
p
= 0.002). Stiffness did not correlate with cell number and was inversely correlated with microvessel density. Fibrosis was higher in nodules with LoEl than in those with HiEl (
p
= 0.009) and in carcinomas than in benign nodules (
p
= 0.02). Fibrosis was higher in nodules with high expression of Gal-3 (
p
< 0.001) and FN-1 (
p
= 0.004). Fibrosis and expression of Gal-3 and FN-1 were higher in the classic compared with the follicular variant of papillary thyroid carcinoma and lower in follicular adenomas.
Conclusions:
Low elasticity at US elastography is highly correlated with malignancy. Nodule stiffness is correlated with fibrosis and expression of Gal-3 and FN-1. These features are more evident in the classic than in the follicular variant of papillary thyroid carcinoma.</abstract><cop>United States</cop><pub>Mary Ann Liebert, Inc</pub><pmid>27809694</pmid><doi>10.1089/thy.2016.0341</doi><tpages>98</tpages><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1050-7256 |
| ispartof | Thyroid (New York, N.Y.), 2017-01, Vol.27 (1), p.13-110 |
| issn | 1050-7256 1557-9077 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_1836731346 |
| source | MEDLINE; Alma/SFX Local Collection |
| subjects | Adenoma - diagnostic imaging Adenoma - metabolism Adenoma - pathology Adult Carcinoma - diagnostic imaging Carcinoma - metabolism Carcinoma - pathology Diagnosis, Differential Elasticity Elasticity Imaging Techniques Female Fibronectins - metabolism Fibrosis - diagnostic imaging Fibrosis - metabolism Fibrosis - pathology Galectin 3 - metabolism Humans Male Middle Aged Thyroid Neoplasms - diagnostic imaging Thyroid Neoplasms - metabolism Thyroid Neoplasms - pathology Thyroid Nodule - diagnostic imaging Thyroid Nodule - metabolism Thyroid Nodule - pathology Thyroid Radiology and Nuclear Medicine |
| title | Low Elasticity of Thyroid Nodules on Ultrasound Elastography Is Correlated with Malignancy, Degree of Fibrosis, and High Expression of Galectin-3 and Fibronectin-1 |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-06T10%3A28%3A09IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_cross&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Low%20Elasticity%20of%20Thyroid%20Nodules%20on%20Ultrasound%20Elastography%20Is%20Correlated%20with%20Malignancy,%20Degree%20of%20Fibrosis,%20and%20High%20Expression%20of%20Galectin-3%20and%20Fibronectin-1&rft.jtitle=Thyroid%20(New%20York,%20N.Y.)&rft.au=Rago,%20Teresa&rft.date=2017-01-01&rft.volume=27&rft.issue=1&rft.spage=13&rft.epage=110&rft.pages=13-110&rft.issn=1050-7256&rft.eissn=1557-9077&rft_id=info:doi/10.1089/thy.2016.0341&rft_dat=%3Cproquest_cross%3E1836731346%3C/proquest_cross%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=1836731346&rft_id=info:pmid/27809694&rfr_iscdi=true |