Differentiating thyroid nodules parathyroid lesions using 2D-shear-wave elastography: a novel approach for enhanced...

Area of Science:

• Medical Imaging
• Endocrinology
• Oncology

Background:

• Distinguishing thyroid and parathyroid lesions using conventional ultrasound can be challenging.
• Accurate differentiation is crucial for appropriate patient management and treatment planning.

Purpose of the Study:

• To evaluate the diagnostic efficacy of bidimensional shear wave elastography planewave ultrasound (2D SWE PLUS) in differentiating thyroid nodules from parathyroid lesions.
• To assess 2D SWE PLUS as an auxiliary tool to enhance conventional ultrasonography for superficial neck structures.

Main Methods:

• Eighty-six patients with concurrent thyroid nodules and hyperparathyroidism were evaluated.
• Conventional ultrasound and 2D SWE PLUS were performed using an Aixplorer Supersonic Mach30 with a 5-18 MHz linear probe.
• Elasticity index (EI) values were statistically analyzed to compare parathyroid tissue, normal thyroid tissue, and thyroid nodules.

Main Results:

• Significant differences in EI were found between parathyroid and normal thyroid tissue (p<0.0001), and between parathyroid lesions and thyroid nodules (p<0.0001).
• 2D SWE PLUS achieved high diagnostic performance with an area under the curve (AUC) of 0.961 for parathyroid vs. normal thyroid tissue (cut-off ≤8.9 kPa) and 0.963 for parathyroid vs. thyroid lesions (cut-off 9.24 kPa).
• Elevated elasticity values were observed in thyroid cancer compared to benign thyroid nodules (p<0.0001).

Conclusions:

• 2D SWE PLUS is a highly effective tool for differentiating thyroid nodules from parathyroid lesions.
• This technique significantly enhances diagnostic performance in neck ultrasonography, aiding in the distinction of these superficial structures.
• The findings support the integration of 2D SWE PLUS into routine ultrasonography for improved diagnostic accuracy in endocrine neck imaging.