Shear wave elastography for thyroid nodule evaluation in patients with chronic autoimmune thyroiditis.

Area of Science:

• Medical Imaging
• Oncology
• Endocrinology

Background:

• Shear wave elastography (SWE) is recognized for its utility in evaluating thyroid nodule malignancy risk.
• Chronic autoimmune thyroiditis (CAT) presents diagnostic challenges due to fibrosis-induced tissue stiffness, potentially affecting elastography accuracy.
• Distinguishing malignant from benign thyroid nodules is crucial for appropriate patient management.

Purpose of the Study:

• To investigate the reliability of 2D-SWE in differentiating malignant thyroid nodules within the context of CAT.
• To assess the effectiveness of 2D-SWE in overcoming diagnostic complexities introduced by fibrosis in CAT patients.

Main Methods:

• A retrospective observational study involving 130 thyroid nodules (39 malignant, 91 benign) in patients with CAT.
• Nodules were assessed using conventional ultrasound (B-mode) and 2D-SWE (SuperSonic Mach30).
• Pathology reports served as the gold standard for diagnosis.

Main Results:

• 2D-SWE demonstrated excellent performance in distinguishing between benign and malignant nodules.
• Malignant nodules exhibited significantly higher mean (47.2 kPa) and maximum (75 kPa) elasticity indices compared to benign nodules (18.1 kPa and 26.2 kPa, respectively; p < 0.0001).
• The mean elasticity index was the most effective parameter, showing an AUC of 0.907, with 87.2% sensitivity and 84.6% specificity for a cut-off of 30.5 kPa.

Conclusions:

• 2D-SWE accurately diagnoses malignant thyroid nodules in patients with CAT, confirming its diagnostic value.
• The findings support the integration of 2D-SWE as a complementary tool alongside conventional ultrasound for improved thyroid nodule assessment.
• 2D-SWE offers a reliable method for risk stratification of thyroid nodules, even in the presence of autoimmune thyroiditis.