Application of shear wave elastography (SWE) in the management of thyroid nodules in children and adolescents

Artur Bossowski; Hanna Borysewicz-Sanczyk; Filip Bossowski; Beata Sawicka; Katarzyna Anikiej; Justyna Michalak; Janusz Dzięcioł

doi:10.1530/endoabs.101.PS1-09-04

PS1-09-04

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Endocrine Abstracts (2024) 101 PS1-09-04 | DOI: 10.1530/endoabs.101.PS1-09-04

ETA2024 Poster Presentations Nodules (10 abstracts)

Application of shear wave elastography (SWE) in the management of thyroid nodules in children and adolescents

Artur Bossowski ¹ , Hanna Borysewicz-Sanczyk ² , Filip Bossowski ³ , Beata Sawicka ⁴ , Katarzyna Anikiej ⁵ , Justyna Michalak ⁶ & Janusz Dzięcioł ⁷

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¹Medical University in Bialystok, Department of Paediatric, Endocrinology and Diabetes, With A Cardiology Division. Medical University in Bialystok, Jerzego Waszyngtona 17 15-274 Białystok, Department of Paediatric, Endocrinology and Diabetes With A Cardiology Division, Białystok, Poland; ²Medical University in Bialystok, Poland, Department of Paediatric, Endocrinology and Diabetes With A Cardiology Division, Bialystok, Poland; ³Medical University in Bialystok., Department of Paediatric, Endocrinology and Diabetes With A Cardiology Division, Bialystok, Poland; ⁴Medical University in Bialystok, Poland, [email protected], Dep. of Pediatric Endocrinology and Diabetes With A Cardiology Unit., Białystok, Poland; ⁵Medical University in Bialystok, Department of Paediatric, Endocrinology and Diabetes With A Cardiology Division, Bialystok, Poland; ⁶University Children Hospital in Bialystok, Department of Pediatric Endocrinology and Diabetes With A Cardiology Unit, Bialystok, Poland; ⁷Medical University in Bialystok, Poland, Department of Human Anatomy, Bialystok, Poland

Background: Shear wave elastography (SWE) is an ultrasound diagnostic method used to measure tissue stiffness. Since the mechanical properties of tissue involved in the pathological process are changed, SWE might indicate regions of the examined tissue covered by the disease. It is well documented, that SWE helps to differentiate benign and malignant nodules in thyroid gland in adults, however there are still few studies on application of SWE in thyroid diagnosis in children. The purpose of the study was to assess the application of SWE based on Young’s modulus expressed in kPa in the management of thyroid nodules in children and adolescents.

Methods: 116 pediatric patients (81 girls and 35 boys) with 168 thyroid nodules were enrolled to the study and were qualified to SWE which followed fine needle aspiration biopsy.

Results: According to the result of cytological examination presented in Bethesda system, nodules were qualified as benign (147 nodules with II category according to Bethesda system) and suspected (21 nodules with III, IV and V category according to Bethesda system). Benign cytological diagnosis were nodular goiter, parenchymal goiter, nodular colloid goiter or lymphocytic inflammation. Among suspected nodules 15 were diagnosed as III according to Bethesda system (AUS - Atypia of Undetermined Significance or FLUS - Follicular Lesion of Undetermined Significance in cytology), 1 nodule was diagnosed as IV according to Bethesda system (suspicious for follicular neoplasm - oxyphilic cell tumor) and 5 as V according to Bethesda system (suspicious for malignancy). There were no significant differences between TSH and fT4 concentration between benign and suspicious group. Patients with benign and suspected thyroid nodules were of comparable age. Mean SWE in benign nodules was statistically significant lower than in nodules with suspected cytology (42.22±16.69 vs. 57.4±24.0 kPa, P = 0.0004). Moreover there was a significant correlation between the Bethesda scale and SWE values. 5 patients from suspicious group revealed to be malignant in final histopathological examination.

Conclusion: Our results suggest that SWE is a viable diagnostic method, however it still seems to need some adjustment for pediatric patients.

Keywords: ultrasonography, elastography, nodules, children