Endocrine Abstracts

Objectives: Distinguishing between a healthy thyroid and autoimmune thyroid disease can sometimes be challenging. In addition to clinical and laboratory tools, as well as thyroid ultrasound, additional diagnostic tool is the elastographic assessment of thyroid tissue. With our research, we aimed to determine if we could differentiate between thyroid tissue in patients with Graves’ disease (GD) and subjects with a healthy thyroid using ultrasound shear wave elastography (SWE).

Methods: In our prospective study, we evaluated 95 participants, comprising newly diagnosed GD patients and healthy individuals. GD diagnosis relied on clinical presentation, biochemical hyperthyroidism, positive antibodies against TSH receptor (TSHRAb), and a hypoechoic inhomogeneus ultrasound pattern of the thyroid gland. Healthy participants exhibited euthyroidism, negative thyroid autoantibodies, and an isoechoic homogeneous ultrasound thyroid appearance. SWE was employed in all participants to measure shear wave velocity (v_sw) and calculate the elasticity expressed in kPa. We utilized ROC analysis to assess the effectiveness of the SWE method, expressing its accuracy through AUC measurement.

Results: The GD group consisted of 42 patients (16.7% males and 83.3% females) with a mean age of 40.9±12.8 years. The healthy group comprised 53 individuals (22.6% males and 77.4% females) with a mean age of 46.3±15.7 years. In the GD group, the median v_sw was significantly higher compared to healthy participants (2.80 m/s (range, 1.26–4.17) vs 2.11 m/s (range, 1.39–3.42), P < 0.001). This corresponds to the median calculated elasticity of the thyroid gland, which was 23.1 kPa (range, 4.75–52.20) in the GD group and 13.3 kPa (range, 5.83–35.0) in the healthy group (P < 0.001). Furthermore, the determined optimal cut-off point for v_sw was 2.65 m/s, yielding a specificity of 92.5%, sensitivity of 66.7%, and an AUC of 0.804. Regarding calculated elasticity, the optimal cut-off point was found to be 18.48 kPa, with a specificity of 90.6%, sensitivity of 71.4%, and an AUC of 0.814.

Conclusions: The stiffness of thyroid tissue is significantly higher in patients with GD than in healthy subjects. Our results indicate that SWE elastography represents a useful tool that allows differentiation of thyroid elasticity between GD and a healthy thyroid with excellent specificity and adequate sensitivity.