Acoustic radiation force impulse (ARFI)-imaging is a novel ultrasound-based elastography method enabling quantitative measurement of tissue stiffness. This study aimed to evaluate diagnostic value of conventional ultrasound and tissue quantification by using acoustic radiation force impulse (ARFI) technology for differentiation of small thyroid solid lesions. Ninety thyroid masses were examined by using the conventional ultrasound and Virtual touch tissue quantification (VTQ) of ARFI. The shear

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... wave velocity (SWV) (m/s) was also examined. Combined traditional ultrasound diagnosis criteria (CTUDC) of thyroid nodules were also evaluated. Receiver-operating characteristic curve (ROC) analysis was performed to assess the diagnostic performance. The final diagnosis was obtained from clinical histology findings. In conventional ultrasound patterns, A/T ≥ 1 had the highest area under curve, which could achieve to 0.6547. The mean value of SWV of thyroid microcarcinoma differed significantly from those of benign nodules (3.92±2.01 m/s vs. 2.52±1.09 m/s, P < 0.01). For differentiating between benign and malignant nodules, the sensitivity, specificity were 80.56% and 74.07%, respectively, which were based on the standard SWV (2.57 m/s). Meanwhile, the sensitivity and specificity could achieve 77.78% and 77.22%, respectively, which were based on CTUDC. The Area under ROC curve (AUC) of VTQ and CTUDC were 0.825 and 0.8226 respectively. Among the ninety thyroid masses, only five benign lesions were misdiagnosis as malignant ones if combination application of VTQ and CTUDC. In conclusion, the VTQ of ARFI technology can be applied in diagnosis of small thyroid nodules, which may be complement B-mode ultrasound and plays an important role in clinical applications.