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      Differentiating thyroid nodules parathyroid lesions using 2D-shear-wave elastography: a novel approach for enhanced diagnostic accuracy

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          Abstract

          Differentiating between thyroid and parathyroid lesions by means of ultrasound can be a challenge in some cases. This study explores the diagnostic efficacy of bidimensional shear wave elastography planewave ultrasound (2D SWE PLUS) as an auxiliary technique in distinguishing these superficial structures. We evaluated 86 cases, presenting with concurrent thyroid nodules and hyperparathyroidism, through conventional ultrasound and 2D SWE PLUS, employing an Aixplorer Supersonic Mach30 with a 5-18 MHz linear probe. Statistically significant differences were observed for the elasticity index (EI) between parathyroid and normal thyroid tissue (p<0.0001, U=291), and between parathyroid lesions and thyroid nodules (p<0.0001, U=248.5). An area under the curve (AUC) of 0.961, with an optimal cut-off value of ≤8.9 kPa, was established to effectively distinguish parathyroid tissue from normal thyroid tissue (sensitivity of 91.9%; specificity of 97.5%). Furthermore, an AUC of 0.963 and an optimal cut-off of 9.24 kPa (sensitivity of 94.2%, specificity of 91.1%) were determined for parathyroid vs thyroid lesions. Elasticity values were significantly elevated in the cancer group compared to benign thyroid nodules (p<0.0001). Our findings suggest that 2D SWE PLUS is an effective tool in differentiating between thyroid nodules and parathyroid lesions, enhancing diagnostic performance in neck ultrasonography.

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          Most cited references39

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          Ultrasound Elastography: Review of Techniques and Clinical Applications

          Elastography-based imaging techniques have received substantial attention in recent years for non-invasive assessment of tissue mechanical properties. These techniques take advantage of changed soft tissue elasticity in various pathologies to yield qualitative and quantitative information that can be used for diagnostic purposes. Measurements are acquired in specialized imaging modes that can detect tissue stiffness in response to an applied mechanical force (compression or shear wave). Ultrasound-based methods are of particular interest due to its many inherent advantages, such as wide availability including at the bedside and relatively low cost. Several ultrasound elastography techniques using different excitation methods have been developed. In general, these can be classified into strain imaging methods that use internal or external compression stimuli, and shear wave imaging that use ultrasound-generated traveling shear wave stimuli. While ultrasound elastography has shown promising results for non-invasive assessment of liver fibrosis, new applications in breast, thyroid, prostate, kidney and lymph node imaging are emerging. Here, we review the basic principles, foundation physics, and limitations of ultrasound elastography and summarize its current clinical use and ongoing developments in various clinical applications.
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            Worldwide Thyroid-Cancer Epidemic? The Increasing Impact of Overdiagnosis

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              Evolving Understanding of the Epidemiology of Thyroid Cancer

              The incidence of thyroid cancer worldwide has increased significantly over the past 3 decades, due predominantly to an increase in papillary thyroid cancer. Although most of these cancers are small and localized, population-based studies have documented a significant increase in thyroid cancers of all sizes and stages, in addition to incidence-based mortality for papillary thyroid cancer. This suggests that the increasing incidence of thyroid cancer is due in large part to increasing surveillance and overdiagnosis, but that there also appears to be a true increase in new cases of thyroid cancer.
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                Author and article information

                Contributors
                Journal
                Front Endocrinol (Lausanne)
                Front Endocrinol (Lausanne)
                Front. Endocrinol.
                Frontiers in Endocrinology
                Frontiers Media S.A.
                1664-2392
                31 July 2023
                2023
                : 14
                : 1231784
                Affiliations
                [1] 1 Discipline of Endocrinology, Second Department of Internal Medicine, University of Medicine and Pharmacy “Victor Babes” , Timisoara, Romania
                [2] 2 Centre for Molecular Research in Nephrology and Vascular Disease, “Victor Babeş” University of Medicine and Pharmacy , Timişoara, Romania
                [3] 3 Clinic of Endocrinology, Timiş County Emergency Clinical Hospital , Timisoara, Romania
                [4] 4 Discipline of Nephrology, Second Department of Internal Medicine, University of Medicine and Pharmacy “Victor Babes” , Timisoara, Romania
                [5] 5 Dialysis Unit, Dialysis Medical Center B Braun Avitum , Timisoara, Romania
                [6] 6 Second Discipline of Surgical Semiology, First Department of Surgery, University of Medicine and Pharmacy “Victor Babes” , Timisoara, Romania
                Author notes

                Edited by: Takahisa Hiramitsu, Japanese Red Cross Nagoya Daini Hospital, Japan

                Reviewed by: Grzegorz Wiktor Kaminski, Military Institute of Medicine, Poland; Jeehee Yoon, Chonnam National University Bitgoeul Hospital, Republic of Korea

                *Correspondence: Andreea Borlea, borlea.andreea@ 123456umft.ro
                Article
                10.3389/fendo.2023.1231784
                10425532
                7da91ad5-e97e-4c98-b0ab-2e8a8196b3e0
                Copyright © 2023 Stoian, Borlea, Taban, Maralescu, Bob, Schiller, Schiller and Neagoe

                This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

                History
                : 30 May 2023
                : 12 July 2023
                Page count
                Figures: 8, Tables: 4, Equations: 0, References: 39, Pages: 10, Words: 4213
                Categories
                Endocrinology
                Original Research
                Custom metadata
                Thyroid Endocrinology

                Endocrinology & Diabetes
                hyperparathyroidism,thyroid nodules,elastography,2d-swe,neck ultrasonography,parathyroid adenomas

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