Diagnostic Value of Shear Wave Elastography for Parathyroid Adenomas

Clinicians may be able to reliably diagnose parathyroid adenomas (PAs) and differentiate them from benign thyroid lesions (BTLs) on the basis of the elasticity of the lesion with the use of shear wave elastography (SWE), according to a study published in Endocrine.

Researchers identified and selected 65 individuals with PAs and 35 individuals with a total of 51 benign thyroid nodules who underwent imaging using SWE, prehistological confirmation of pathology, to determine whether SWE would be a valuable and reliable tool to accurately diagnose pathologically enlarged parathyroids. There was no significant difference in age distribution, and the average lesion size difference was of borderline significance between the 2 groups (P =.03). Histopathology was confirmed after surgical intervention to remove the tumor.

Study results found significant differences between the 2 groups (PAs vs BTLs) with significant differences in elastographic parameters between PAs and BTLs. PAs were found to be significantly more elastic than BTLs with a Q-box mean that was almost 5 times lower than BTLs (mean elasticity, 5.2±7.2 vs 24.3±33.8 kPa, respectively). In addition, the mean elasticity of the tumor in comparison with the thyroid tissue surrounding it was significantly lower in PAs compared with BTLs (0.30±0.36 and 2.8±3.9, respectively).

SWE was found to be quite reliable, as less than 5% of lesions presented on exam to have stiffness that was higher than the average Q-box mean value among BTL, thereby rendering it a reliable tool in the majority of clinical cases to exclude the suspicion of PAs.

Researchers concluded that enlarged PAs were found to be significantly more elastic than BTLs, and the use of SWE can be a valuable tool for preliminary diagnosis of PAs. “Although the SWE itself does not allow for fully reliable differentiation of [PAs] and thyroid lesions and should be interpreted carefully, in context of other examinations, it can be considered as valuable, additional diagnostic tool,” concluded the researchers.

Reference

Stangierski A, Wolinski K, Ruchala M. Shear wave elastography in the diagnostics of parathyroid adenomas-new application of the method [published online February 21, 2018]. Endocrine. doi: 10.1007/s12020-018-1553-0