[Reproducibility of lesion stiffness measured by shear wave elastography in Hashimoto's thyroiditis combined with...

Objective:To analyze the repeatability of shear wave imaging（SWE） to measure hardness of Hashimoto thyroiditis（HT） complicated with thyroid cancer（TC）, and the relationship between hardness and pathological features. Methods:This study enrolled 90 patients who underwent thyroid surgery and preoperative ultrasound examination at the Department of General Surgery, the First Affiliated Hospital of Naval Medical University between January 2023 and January 2025. Based on postoperative pathological findings, patients were divided into two groups: Hashimoto's thyroiditis with thyroid carcinoma （n=58） and Hashimoto's thyroiditis alone （n=32）. The general data and pathological characteristics of the patients were collected. The receiver operating characteristic（ROC） curve was used to evaluate the value of SWE in the differential diagnosis of HT with TC and its different pathological features. Spearman rank correlation analysis was used to analyze the correlation between lesion stiffness and pathological characteristics of HT combined with TC. The intraclass correlation coefficient（ICC） was calculated to verify the repeatability of the lesion stiffness measured by the operators and among different operators. Results:The hardness value of HT lesions was（25.79±6.14） kPa, and the hardness value of HT combined with TC was（62.34±8.71） kPa, and the difference was statistically significant（t=21.008, P<0.001）. The ROC curve showed that the SWE technique had a good diagnostic efficacy for HT combined with TC（AUC >0.80, P<0.05）. The lesion stiffness was correlated with lymph node metastasis, capsular invasion, tumor diameter and tumor stage, and the difference was statistically significant（P<0.05）, and was positively correlated with tumor diameter（r=0.628, P<0.001） and tumor stage（r=0.850, P<0.001）. The AUC of SWE in identifying tumor stage ≥Ⅱ, tumor stage Ⅳ, tumor diameter≥1 cm, lymph node metastasis and capsular invasion were 0.806（95%CI 0.746-0.839）, 0.815（95%CI 0.758-0.862） and 0.811（95%CI 0.758-0.862）, 0.742（95%CI 0.707-0.796）, 0.795（95%CI 0.724-0.878）. The intra-group ICC and intra-group ICC of lesion stiffness measured by different operators and the same operator were greater than 0.75, and the agreement was very good. Conclusion:The measurement of SWE parameters has high repeatability in the evaluation of the hardness of HT combined with TC lesions, and is closely related to some clinicopathological characteristics, which provides key references for clinical diagnosis and treatment and helps to formulate accurate diagnosis and treatment plans.