EFSUMB EUROPEAN FEDERATION OF SOCIETIES FOR ULTRASOUND IN MEDICINE AND BIOLOGY ‘Building a European Ultrasound Community’ Young Investigator’s Award WFUMB 2011 VIENNA AUSTRIA 28 August 2011 13.50 – 15.45 10 minutes each for presentation plus 3 minutes discussion
Thyroid Elastography for diffuse pathology: feasibility and practical utility Simona Bota¹, Ioan Sporea¹, Mihaela Vlad², Roxana Sirli¹, Alina Popescu¹, Mirela Danila¹, Madalina Sendroiu¹, Ioana Zosin² ¹Department of Gastroenterology and Hepatology, University of Medicine and Pharmacy, Timisoara, Romania ²Department of Endocrinology, University of Medicine and Pharmacy, Timisoara, Romania
ABSTRACT Introduction ARFI technique (Acoustic Radiation Force Impulse Elastography) is a new method used for the assessment of liver fibrosis, breast nodules and other pathologies, offered by Siemens and integrated into an ACUSSON S2000 system. Aim To evaluate thyroid stiffness (TS) assessed by means of ARFI as a predictor of thyroid pathology. Methods We evaluated 111 patients, mean age 46.3±14.2 years, 84 women and 27 men: 41 without thyroid pathology, 42 with Basedow disease and 28 with chronic autoimmune thyroiditis-CAT (diagnosed by specific tests). For all patients, 10 elastography measurements were made in the right thyroid lobe (RTL) and 10 in the left thyroid lobe (LTL) using a convex probe of 1-4.5 MHZ. Median values were calculated, expressed in meters/second (m/s). We also calculated mean TS values from the RTL and LTL. In 31 patients we performed 10 elastographic measurements in RTL and LTL each, using a convex probe of 1-4.5 MHz and a linear probe of 4-9 MHz, respectively. We also calculated mean TS values for each probe (resulted from the median TS values in RTL and LTL). For statistical analysis we used the receiver operating characteristics (ROC) curve and t test. Results Mean TS values assessed by ARFI were: in subjects without thyroid pathology: 2.01±0.40 m/s, in Basedow disease 2.65±0.53 m/s and in CAT: 2.54±0.56 m/s. TS in healthy subjects was statistically significant lower than in Basedow (p<0.0001) and CAT patients (p<0.0001), but the differences were not statistically significant in Basedow vs. CAT patients (p=0.32). For a cut-off value > 2.36 m/s, TS had 65.7% sensitivity, 82.9% specificity, 86.7% predictive positive value, 58.6% negative predictive value and 72.1% accuracy for the prediction of diffuse thyroid gland pathology (AUROC=0.80). TS values assessed by means of convex probe were higher, but not statistically significant than those obtained with the linear probe (2.09±0.39 m/s vs. 2.03±0.36 m/s, p=0.55). Thereafter, this cut-off was used to evaluate diffuse thyroid gland pathology. Conclusion ARFI seems to be a useful method for the evaluation of diffuse thyroid gland pathology.