Multiparametric ultrasound-based assessment of overt hyperthyroid diffuse thyroid disease

Area of Science:

• Endocrinology
• Medical Imaging
• Diagnostic Ultrasound

Background:

• Hyperthyroidism affects 1.2% of the global population, necessitating efficient diagnostic tools.
• Diffuse thyroid disease (DTD) is a common cause of hyperthyroidism.
• Current diagnostic methods can be improved with systematic, multiparametric approaches.

Purpose of the Study:

• To establish and validate a systematic diagnostic algorithm for hyperthyroid diffuse thyroid disease (DTD) using multiparametric ultrasound (MPUS).
• To evaluate the diagnostic performance of B-mode ultrasound, Doppler, and shear wave elastography in differentiating DTD subtypes.

Main Methods:

• A retrospective study of 218 patients with clinical hyperthyroidism was conducted.
• Multiparametric ultrasound (MPUS) including B-mode, Color Doppler, Spectral Doppler, and 2D Shear wave elastography (SWE) was employed.
• Patients were biochemically assessed and categorized into DTD subgroups (Graves' disease, subacute thyroiditis, etc.) or healthy controls.

Main Results:

• B-mode hypoechogenicity showed an Area Under the Curve (AUC) of 0.951 for DTD detection.
• Peak systolic velocity effectively differentiated Graves' disease (AUC=1).
• Shear wave elastography (SWE) identified significantly higher elasticity in subacute thyroiditis (AUC=1).

Conclusions:

• A step-by-step MPUS algorithm provides a highly effective diagnostic approach for DTD.
• The combined MPUS parameters achieved an overall diagnostic performance (AUC) of 0.946.
• This systematic ultrasound evaluation aids in the accurate diagnosis of hyperthyroid diffuse thyroid disease.