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Updated: Feb 20, 2026
Author Spotlight: Integrating Ultrasound Imaging with Biochemical Markers for Thyroid Disease Diagnosis
Published on: February 9, 2024
Acoustic Radiation Force Impulse Quantification in the Evaluation of Thyroid Elasticity in Pediatric Patients With
Serap Yucel1, Meltem Ceyhan Bilgici1, Cengiz Kara2
1Departments of Radiology, Ondokuz Mayis University School of Medicine, Samsun, Turkey.
Insights
Acoustic radiation force impulse elastography reveals increased thyroid gland stiffness in pediatric Hashimoto thyroiditis patients compared to healthy children. This imaging technique may aid in predicting autoimmune thyroiditis.
Area of Science:
- Pediatric endocrinology
- Medical imaging
- Rheology
Background:
- Hashimoto thyroiditis is a common autoimmune thyroid disease in children.
- Assessing thyroid gland elasticity can provide insights into disease pathophysiology.
- Non-invasive methods for evaluating thyroid stiffness are needed.
Purpose of the Study:
- To evaluate thyroid parenchymal elasticity using acoustic radiation force impulse (ARFI) imaging in pediatric patients with Hashimoto thyroiditis.
- To compare ARFI-derived shear wave velocity (SWV) values between children with Hashimoto thyroiditis and healthy controls.
Main Methods:
- Acoustic radiation force impulse (ARFI) imaging was used to measure shear wave velocity (SWV) in the thyroid glands of 26 children with Hashimoto thyroiditis and 26 healthy children (ages 6-17).
- SWV values of both thyroid lobes were analyzed and compared between the two groups.
- Receiver operating characteristic (ROC) curve analysis was performed to determine the diagnostic performance of SWV.
Main Results:
- Children with Hashimoto thyroiditis exhibited significantly higher SWV values (1.67 m/s) compared to healthy controls (1.30 m/s) (P < .001).
- ROC analysis indicated an optimal cutoff SWV of 1.41 m/s with 73.1% sensitivity and 80.8% specificity (AUC = 0.806).
- A positive correlation was found between SWV and anti-thyroperoxidase antibody levels in patients with Hashimoto thyroiditis (r = 0.46, P = .038).
Conclusions:
- ARFI elastography demonstrates a significant difference in thyroid gland stiffness between pediatric Hashimoto thyroiditis patients and healthy individuals.
- ARFI imaging shows potential as a non-invasive tool to predict chronic autoimmune thyroiditis in children when used alongside standard ultrasound.
- Thyroid stiffness measured by ARFI may correlate with autoimmune markers in Hashimoto thyroiditis.
Objectives:
To evaluate the parenchymal elasticity of the thyroid gland with acoustic radiation force impulse imaging in pediatric patients with Hashimoto thyroiditis and to compare it with healthy volunteers.
Methods:
Twenty-six patients with Hashimoto thyroiditis and 26 healthy volunteers between 6 and 17 years were included. The shear wave velocity (SWV) values of both thyroid lobes in both groups were evaluated.
Results:
The age and sex characteristics of the controls and patients with Hashimoto thyroiditis were similar. The SWV of the thyroid gland in patients with Hashimoto thyroiditis (mean ± SD, 1.67 ± 0.63 m/s) was significantly higher than that in the control group (1.30 ± 0.13 m/s; P < .001). There was no significant difference between the thyroid lobes in both groups. A receiver operating characteristic curve analyses showed an optimal cutoff value of 1.41 m/s, with 73.1% sensitivity, 80.8% specificity, a 79.2 % positive predictive value, and a 75.0% negative predictive value (area under the curve, 0.806; P < .001). In patients with Hashimoto thyroiditis, there was a positive correlation between the SWV values versus anti-thyroperoxidase (Pearson r = 0.46; P = .038). There were no correlations between age, body mass index, thyroid function test results, and anti-thyroglobulin values and versus SWV values. Also, no significant differences were seen between the groups for gland size, gland vascularity, and l-thyroxine treatment.
Conclusions:
Acoustic radiation force impulse elastography showed a significant difference in the stiffness of the thyroid gland between children with Hashimoto thyroiditis and the healthy group. Using acoustic radiation force impulse elastography immediately after a standard ultrasound evaluation may predict chronic autoimmune thyroiditis.
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