Fig. 13

Transverse strain USE with B mode US images of a papillary carcinoma (left) and hyperplastic nodule (right). Using the qualitative scoring scale from Fig. 11, the cancer appears soft (ES1) whereas the hyperplastic nodule appears mostly stiff (ES3). These would be false negative and false positive for malignancy using most scoring systems published to date, which apply a strain USE threshold of ES3 or greater to predict malignancy