Can ARFI elastography be used to differentiate parathyroid from thyroid lesions?

Area of Science:

• Medical Imaging
• Diagnostic Ultrasound
• Elastography

Background:

• Distinguishing parathyroid lesions from thyroid nodules is crucial for accurate diagnosis and treatment.
• ARFI elastography offers a non-invasive method to assess tissue stiffness.

Purpose of the Study:

• To evaluate the efficacy of ARFI elastography, specifically elasticity score (ES) and shear wave velocity (SWV), in differentiating parathyroid lesions from thyroid nodules.
• To compare the elasticity characteristics of parathyroid lesions and thyroid nodules.

Main Methods:

• ARFI elastography with VTI software was performed on patients with primary hyperparathyroidism or thyroid nodules prior to surgery.
• Histopathological confirmation was obtained for 47 parathyroid lesions, 38 benign thyroid nodules, and 55 malignant thyroid nodules.
• SWV and ES were analyzed, and receiver operating characteristic (ROC) curve analysis was used to assess diagnostic performance.

Main Results:

• Parathyroid lesions exhibited significantly lower mean SWV (1.6 m/s) compared to benign (2.11 m/s) and malignant (4.3 m/s) thyroid nodules (p < 0.05).
• Elasticity score (ES) also significantly differed between parathyroid lesions and thyroid nodules (Chi square = 51.6, p < 0.001).
• Speckled appearance on VTI, ES, and SWV showed diagnostic performances of 0.901, 0.724, and 0.797, respectively, for differentiating lesion types.

Conclusions:

• Parathyroid lesions are characterized by lower stiffness (softer tissue) compared to thyroid nodules.
• ARFI elastography measurements, particularly SWV, can reliably differentiate between parathyroid lesions and thyroid nodules, with a SWV of 1.72 m/s serving as a key differentiator.