Endocrine Abstracts

Finding of a firm nodule during palpation of the thyroid gland is one of the clues for malignancy. In addition to palpation, as a new imaging technique, tissue stiffness can be evaluated by ultrasound elastography (USE); thereby helping us further to detect firm thyroid nodules, even the non-palpable ones. Tissue stiffness is detected by USE through measuring the amount of distortion that occurs when the lesions is subjected to external pressure. The power of USE in detecting malignant thyroid nodules was also reported in several studie, in which a high power for this new technique was reported. A recent meta-analysis evaluating most of these reports revealed high sensitivity and specificity for USE.

Studies conducted with USE could mainly be divided into two groups. The first group included thyroid nodules only undergoing surgery and having histopathological diagnoses. The second group included nodules having cytological diagnoses as well as those with histopathological diagnoses. However, all of those studies carry two major limiting factors: (i) small sample size and/or (ii) selection bias. As a result, like initial historical studies evaluating the power of each new ultrasound technique, these preliminary USE studies might overshoot the real sensitivity and specificity. Therefore, we planned to discuss the diagnostic power of USE in detecting malignant thyroid nodules in this MTE session.

Parathyroid adenomas were demonstrated to be elastographically stiff lesions. In contrast, almost half of the parathyroid hyperplasias were soft in elastographic evaluations in our hands. USE seems to be a valuable new assisting technique that might enhance the power of the preoperative localization studies of parathyroid lesions. Moreover, the USE image of a parathyroid lesion may further assist in determining the type of operation that is going to be applied. However, this issue should further be studied to investigate whether parathyroid elastography can also improve postoperative outcomes. We will try to discuss the ultrasound elastographic features of parathyroid lesions as well in this session.

Declaration of interest: The author declares that there is no conflict of interest that could be perceived as prejudicing the impartiality of the research project.

Funding: This research did not receive any specific grant from any funding agency in the public, commercial or not-for-profit sector.