Endocrine Abstracts

An accurate localization diagnosis in parathyroid disease using ultrasound assessment remains a challenge in many instances. The objective of this study is to investigate the diagnostic effectiveness of bidimensional shear wave elastography 2D SWE as a supplementary method for differentiating superficial structures, namely thyroid and parathyroid lesions.

Methods or Background: In this study, a total of 140 cases were assessed, including patients with coexisting benign thyroid nodules and enlarged parathyroid glands due to primary hyperparathyroidism. Final pathology report was used as golden standard of diagnostic. Ultrasound evaluation = multi-parametric ultrasound, SUPERSONIC ULTRAFAST Mach 30 Aixplorer, 3rd software version, with a multifrequency linear probe 5-18MHz.

Results or Findings: There was a statistically significant difference observed for the mean elasticity index between thyroid and parathyroid lesions (15 kPa vs.4.8 kPa, P < 0.001). A cut-off value of 7.5 kPa was established in order to differentiate thyroid from parathyroid tissue (AUC 0.950, Se 93%, Sp 91%), with greatly improved diagnostic performance compared to ultrasound alone (AUC 0.830, Se 71%, Sp 62%). Parathyroid elasticity was correlated negatively and weakly with serum calcium values (r=-0.360, P < 0.001) and positively and weakly with PTH values (r = 0.250, P = 0.035). Our data suggests that 2D-SWE cut-off values can improve diagnostic specificity and sensitivity for correctly diagnosing thyroid nodules and parathyroid lesions.

Conclusion: Differentiating these lesions non-invasively could improve clinical results, diagnostic costs, evaluation time, and invasive treatments.