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Author Spotlight: Integrating Ultrasound Imaging with Biochemical Markers for Thyroid Disease Diagnosis
Published on: February 9, 2024
A Comparative Analysis of Strain and 2D Shear Wave Elastography in the Diagnosis of Autoimmune Thyroiditis in
Cristina Mihaela Roi1, Andreea Borlea2, Monica Simina Mihuta1
1Department of Doctoral Studies, Victor Babes University of Medicine and Pharmacy, 300041 Timisoara, Romania.
Insights
Shear-wave elastography (SWE) and strain elastography (SE) effectively identify chronic autoimmune thyroiditis (CAT) in children. Both methods accurately measure thyroid elasticity, aiding in diagnosis and monitoring of pediatric thyroid changes.
Area of Science:
- Pediatric endocrinology
- Medical imaging
- Rheumatology
Background:
- Chronic autoimmune thyroiditis (CAT) is a common endocrine disorder in children.
- Accurate diagnosis and monitoring of CAT are crucial for effective management.
- Non-invasive imaging techniques are needed to assess thyroid gland changes in pediatric patients.
Purpose of the Study:
- To evaluate the diagnostic utility of shear-wave elastography (SWE) and strain elastography (SE) in identifying chronic autoimmune thyroiditis (CAT) in children.
- To compare the reliability and accuracy of SWE and SE in assessing thyroid tissue elasticity in pediatric patients with CAT.
- To determine optimal cut-off values for SWE and SE in predicting the presence of CAT in children.
Main Methods:
- A comparative study involving 77 children (6-18 years), with 45 diagnosed with CAT and 32 healthy controls.
- Ultrasound, strain elastography (SE), and shear-wave elastography (SWE) were performed on all participants.
- Thyroid elastic index (EI) and strain ratio (SR) were measured using SE and SWE, respectively.
Main Results:
- Children with CAT showed significantly higher median EI (13.8 kPa) and SR (1.2) compared to healthy controls (10.1 kPa and 0.7, respectively) (p < 0.0001 for both).
- Optimal cut-off for SR (>1) yielded Se=82.2%, Sp=87.5%, AUROC=0.850; optimal cut-off for SWE (>12 kPa) yielded Se=88.9%, Sp=93.7%, AUROC=0.943.
- Both SWE and SE demonstrated comparable diagnostic accuracy and reliability in identifying CAT in children.
Conclusions:
- Shear-wave elastography (SWE) and strain elastography (SE) are valuable, non-invasive tools for diagnosing and monitoring thyroid gland changes in children with chronic autoimmune thyroiditis (CAT).
- SWE exhibits slightly higher diagnostic performance than SE for CAT detection in this pediatric cohort.
- These elastographic techniques offer reliable and accurate assessment of thyroid tissue elasticity, supporting their integration into clinical practice for pediatric thyroid evaluation.
Abstract:
This paper aims to assess the usefulness of shear-wave elastography (SWE) and strain elastography (SE) for identifying and monitoring thyroid gland changes in children diagnosed with chronic autoimmune thyroiditis (CAT). Our study included 77 children between the ages of six and eighteen. Of these, 45 were diagnosed with CAT, while 32 had no thyroid pathology. Following a clinical examination and laboratory tests, an ultrasound was carried out, and then a SE (using a Hitachi Preirus machine) and SWE (using an Aixplorer Mach 30, Supersonic imagine, France) were performed in the same session. The median thyroid elastic index (EI) in the CAT group was 13.8 (13.3-17) kPa compared to 10.1 (9.3-11.2) kPa in healthy children (p < 0.0001). We found a median strain ratio (SR) of 1.2 (1.2-1.3) for CAT compared to 0.7 (0.6-0.9) for healthy thyroid tissue (p < 0.0001). The optimal cut-off value for predicting the presence of CAT in children using SR was >1 (Se = 82.2%, Sp = 87.5%, PPV = 90.2%, and NPV = 77.8%, AUROC = 0.850), while using SWE, the optimal cut-off value for predicting the presence of CAT in children was >12 kPa (Se = 88.9%, Sp = 93.7%, PPV = 95.2%, and NPV = 85.5%, AUROC = 0.943). Both techniques are useful for measuring thyroid tissue elasticity, and their diagnostic accuracy and reliability are comparable.
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