Shear wave elastography and parathyroid adenoma: A new tool for diagnosing parathyroid adenomas

Objectives. The aim of the study was to compare elastographic means in parathyroid adenomas, using shear wave elastography and strain elastography. Methods. This prospective study examined 20 consecutive patients diagnosed with primary hyperparathyroidism and parathyroid adenoma, confirmed by biochemical assay, technetium-99 sestamibi scintigraphy, and pathology report, after parathyroid surgery. All patients were examined on conventional 2B ultrasound, 2D shear wave elastography, and strain elastography. We determined using 2D shear wave elastography (SWE) the elasticity index (EI) in parathyroid adenoma, thyroid parenchyma, and surrounding muscle and examined using strain elastography the parathyroid adenoma, and determined the strain ratio with the thyroid tissue and muscle tissue. Results. All patients had positive sestamibi scintigraphy and underwent surgery, with confirmation of parathyroid adenoma in all cases. The mean parathormone (PTH) value before surgery was 153.29 pg/ml (36.5, 464.8) and serum calcium concentration was 10.5 mg/dl (9, 11.5). We compared using 2D-SWE and strain elastography parathyroid adenoma with thyroid tissue and with surrounding muscle. The mean EI measured by SWE in parathyroid adenoma was 4.74 ± 2.74 kPa and in thyroid parenchyma was 11.718 ± 4.206 kPa (mean difference = 6.978 kPa, p<0.001), and the mean EI value in muscle tissue was 16.362 ± 3.829 kPa (mean difference = 11.622, p<0.001). Using ROC analysis, we found that an EI below 7 kPa correctly identifies parathyroid tissue. We evaluated parathyroid adenomas using strain elastography by color mapping and strain ratio as a semiquantitative measurement; however, we could not find any statistical correlation comparing the strain ratio obtained from the parathyroid adenoma with the thyroid tissue (p=0.485). Conclusion. Ultrasound elastography is a helpful tool in identifying parathyroid adenomas. A cutoff value below 7 kPa can be used in 2D-SWE. Color maps in strain elastography without adding strain ratio can be used, parathyroid adenoma being identified as score 1 in the Rago criteria.

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Diagnotic value of Shear Wave Elastography in differentiating parathyroid adenomas from thyroid nodules

Endocrine Abstracts ◽

10.1530/endoabs.63.p663 ◽

2019 ◽

Author(s):

Mihaela Vlad ◽

Ioana Golu ◽

Maria Oprea ◽

Daniela Amzar ◽

Melania Balas ◽

...

Keyword(s):

Shear Wave ◽

Thyroid Nodules ◽

Shear Wave Elastography ◽

Parathyroid Adenomas

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2D-Shear Wave Elastography in the Evaluation of Parathyroid Lesions in Patients with Hyperparathyroidism

International Journal of Endocrinology ◽

10.1155/2017/9092120 ◽

2017 ◽

Vol 2017 ◽

pp. 1-6 ◽

Cited By ~ 4

Author(s):

Ioana Golu ◽

Ioan Sporea ◽

Lavinia Moleriu ◽

Anca Tudor ◽

Marioara Cornianu ◽

...

Keyword(s):

Parathyroid Adenoma ◽

Shear Wave ◽

Thyroid Tissue ◽

Shear Wave Elastography ◽

Study Groups ◽

Tertiary Hyperparathyroidism ◽

A Value ◽

Parathyroid Lesions ◽

The Mean ◽

Thyroid Parenchyma

Background and Aims. 2D-shear wave elastography (2D-SWE) is a relatively new elastographic technique. The aim of the present study is to determine the values of the elasticity indexes (EI) measured by 2D-SWE in parathyroid benign lesions (adenomas or hyperplasia) and to establish if this investigation is helpful for the preoperative identification of the parathyroid adenoma. Material and Methods. The study groups were represented by 22 patients with primary or tertiary hyperparathyroidism, diagnosed by specific tests, and 43 healthy controls, in whom the thyroid parenchyma was evaluated, in order to compare the EI of the thyroid tissue with those of the parathyroid lesions. Results. The mean EI measured by 2D-SWE in the parathyroid lesions was 10.2 ± 4.9 kPa, significantly lower than that of the normal thyroid parenchyma (19.5 ± 7.6 kPa; p=0.007), indicating soft tissue. For a cutoff value of 12.5 kPa, the EI assessed by 2D-SWE had a sensitivity of 93% and a specificity of 86% (AUC = 0.949; p<0.001) for predicting parathyroid lesions. Conclusion. A value lower than 12.5 kPa for the mean EI measured by 2D-SWE can be used to confirm that the lesion/nodule is a parathyroid adenoma.

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Shear wave elastography in the diagnostics of parathyroid adenomas–new application of the method

Endocrine ◽

10.1007/s12020-018-1553-0 ◽

2018 ◽

Vol 60 (2) ◽

pp. 240-245 ◽

Cited By ~ 3

Author(s):

Adam Stangierski ◽

Kosma Wolinski ◽

Marek Ruchala

Keyword(s):

Shear Wave ◽

Shear Wave Elastography ◽

Parathyroid Adenomas

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Shear Wave Elastography in Patients with Primary and Secondary Hyperparathyroidism

Journal of Clinical Medicine ◽

10.3390/jcm10040697 ◽

2021 ◽

Vol 10 (4) ◽

pp. 697

Author(s):

Daniela Amzar ◽

Laura Cotoi ◽

Ioan Sporea ◽

Bogdan Timar ◽

Oana Schiller ◽

...

Keyword(s):

Primary Hyperparathyroidism ◽

Secondary Hyperparathyroidism ◽

Shear Wave ◽

Muscle Tissue ◽

Parathyroid Tissue ◽

Shear Wave Elastography ◽

The Other ◽

Cutoff Value ◽

Helpful Tool ◽

Parathyroid Adenomas

Objectives: In this study, we aim to determine the elastographic characteristics of both primary and secondary hyperparathyroidism using shear wave elastography. We also aim to evaluate the elastographic differences between them, as well as the differences between the parathyroid, thyroid, and muscle tissue, in order to better identify a cutoff value for the parathyroid tissue. Methods: In this prospective study, we examined a total of 68 patients with hyperparathyroidism, divided into two groups; one group consisted of 27 patients with primary hyperparathyroidism and the other group consisted of 41 selected patients with confirmed secondary hyperparathyroidism. The elasticity index (EI) was determined in the parathyroid, thyroid, and muscle tissue. The determined values were compared to better identify the parathyroid tissue. Results: The median value of mean SWE values measured for parathyroid adenomas from primary hyperparathyroidism was 4.86 kPa. For secondary hyperparathyroidism, the median value of mean SWE was 6.96 KPa. The median (range) presurgical values for parathormone (PTH) and calcium were 762.80 pg/mL (190, 1243) and 9.40 mg/dL (8.825, 10.20), respectively. We identified significant elastographic differences between the two groups (p < 0.001), which remained significant after adjusting elastographic measures to the nonparametric parameters, such as the parathormone value and vitamin D (p < 0.001). The cutoff values found for parathyroid adenoma were 5.96 kPa and for parathyroid tissue 9.58 kPa. Conclusions: Shear wave elastography is a helpful tool for identifying the parathyroid tissue, in both cases of primary and secondary hyperparathyroidism, as there are significant differences between the parathyroid, thyroid, and muscle tissue. We found a global cutoff value for the parathyroid tissue of 9.58 kPa, but we must keep in mind that there are significant elastographic differences between cutoffs for primary and secondary hyperparathyroidism.

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Real-time shear wave elastography in the evaluation of parathyroid adenomas

Endocrine Abstracts ◽

10.1530/endoabs.37.ep1138 ◽

2015 ◽

Author(s):

Mihaela Vlad ◽

Ioana Golu ◽

Daniela Amzar ◽

Melania Balas ◽

Ioana Zosin ◽

...

Keyword(s):

Real Time ◽

Shear Wave ◽

Shear Wave Elastography ◽

Parathyroid Adenomas

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The diagnostic value of shear wave elastography for parathyroid lesions and comparison with cervical lymph nodes

Medical Ultrasonography ◽

10.11152/mu-1089 ◽

2017 ◽

Vol 19 (4) ◽

pp. 386 ◽

Cited By ~ 5

Author(s):

Ahmet Veysel Polat ◽

Mesut Ozturk ◽

Behic Akyuz ◽

Cetin Celenk ◽

Mehmet Kefeli ◽

...

Keyword(s):

Lymph Nodes ◽

Shear Wave ◽

Shear Wave Elastography ◽

Parathyroid Hyperplasia ◽

Tissue Imaging ◽

Roc Curve Analysis ◽

Cervical Lymph Nodes ◽

Parathyroid Adenomas ◽

Parathyroid Lesions ◽

The Mean

Aims: The aim of this study was to prospectively assess the feasibility of the Virtual Touch tissue imaging quantification (VTIQ) method of shear wave elastography (SWE) for the discrimination of parathyroid lesions and to compare the lesions’ stiffness with that of cervical lymph nodes.Materials and methods: SWE using VTIQ was performed on 66 patients with 87 histopathologically proven parathyroid lesions (54 parathyroid adenomas and 33 parathyroid hyperplasia) and 29 patients with 31 inflammatory cervical lymph nodes. The mean SWVs of the lesions were compared and receiver operating characteristic (ROC) curve analysis was used to evaluate diagnostic performance.Results: The mean SWV of parathyroid adenomas (2.16±0.33 m/s) differed significantly from those of parathyroid hyperplasia and lymph nodes (1.75±0.28 m/s and 1.86±0.37 m/s respectively, p<0.001). Selecting a cutoff value of 1.92 m/s for diagnosing adenoma led to 80% sensitivity and 82% specificity (area under the curve [AUC]: 0.832 [95% confidence interval (CI): 0.742–0.921], p< 0.001).Conclusions: The VTIQ method of SWE can contribute to the differentiation of parathyroid adenoma from parathyroid hyperplasia and cervical lymphnodes.

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Liver Elastography in Healthy Children Using Three Different Systems – How Many Measurements Are Necessary?

Ultraschall in der Medizin - European Journal of Ultrasound ◽

10.1055/a-1283-5906 ◽

2020 ◽

Author(s):

Anders Batman Mjelle ◽

Anesa Mulabecirovic ◽

Roald Flesland Havre ◽

Edda Jonina Olafsdottir ◽

Odd Helge Gilja ◽

...

Keyword(s):

Shear Wave ◽

Transient Elastography ◽

Intraclass Correlation ◽

Age Groups ◽

Liver Stiffness ◽

Shear Wave Elastography ◽

Healthy Children ◽

Significant Difference ◽

Pediatric Liver Disease ◽

Liver Elastography

Abstract Purpose Liver elastography is increasingly being applied in screening for and follow-up of pediatric liver disease, and has been shown to correlate well with fibrosis staging through liver biopsy. Because time is of the essence when examining children, we wanted to evaluate if a reliable result can be achieved with fewer acquisitions. Materials and Methods 243 healthy children aged 4–17 years were examined after three hours of fasting. Participants were divided into four age groups: 4–7 years; 8–11 years; 12–14 years and 15–17 years. Both two-dimensional shear wave elastography (2D-SWE; GE Logiq E9) and point shear wave elastography (pSWE; Samsung RS80A with Prestige) were performed in all participants, while transient elastography (TE, Fibroscan) was performed in a subset of 87 children aged 8–17 years. Median liver stiffness measurement (LSM) values of 3, 4, 5, 6, 7, and 8 acquisitions were compared with the median value of 10 acquisitions (reference standard). Comparison was performed for all participants together as well as within every specific age group. We investigated both the intraclass correlation coefficient (ICC) with absolute agreement and all outliers more than 10 %, 20 % or ≥ 0.5 or 1.0 kPa from the median of 10 acquisitions. Results For all three systems there was no significant difference between three and ten acquisitions, with ICCs ≥ 0.97. All systems needed 4 acquisitions to achieve no LSM deviating ≥ 1.0 kPa of a median of ten. To achieve no LSM deviating ≥ 20 % of a median of ten acquisitions, pSWE and TE needed 4 acquisitions, while 2D-SWE required 6 acquisitions. Conclusion Our results contradict recommendations of 10 acquisitions for pSWE and TE and only 3 for 2D-SWE.

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