Comparison of thyroid scintigraphy and ARFI-elastography in autoimmune thyroid diseases

Year 2022, Volume: 5 Issue: 2, 504 - 509, 15.03.2022

İlhan Sezgin , Bekir Taşdemir , Faruk Kilinc , Cihad Hamidi , Mahmut Çoraplı

https://doi.org/10.32322/jhsm.1055864

Abstract

Aim: To compare the ARFI elastographic and scintigraphic quantitative data obtained from thyroid gland and to evaluate diagnostic value of ARFI elastographic measurements in autoimmune thyroid diseases.
Material and Method: In the study a total of 61 patients (41 women, 20 men) including 24 Graves’ disease, 15 Hashimoto disease and 22 control subjects. The patients mean age was 33.9±10.9 years. Patients with thyroid nodules were not included in the study. Thyroid uptake was performed with Tc 99m pertechnetate and the elastosonography score of the thyroid gland was determined with ARFI. Findings of both disease groups were statistically compared with each other and control group
Results: For thyroid uptake test; a statistically significant difference was found between two disease (p < 0.001) and between each disease and control group (p < 0.001 for Hashimoto, p <0.001 for Graves). However, for ARFI method; a statistically significant difference was not found between two disease (p=0.336) and between each disease and control group (p=0.14 for Hashimoto, p=0.08 for Graves).
Conclusion: Thyroid scan and thyroid uptake measurements are extremely valuable in differential diagnosis of autoimmune thyroid diseases and ARFI elastosonographic measurements don’t seem to replace scintigraphic datas.

Keywords

Thyroid scintigraphy, Thyroid uptake, ARFI, Graves’ disease, Hashimoto

References

• Görpe A, Cantez S. Endokrin sistem. Pratik Nükleer Tıp; 1. Baskı, 195-219, İstanbul Tıp Fakültesi Vakfı, İstanbul, 1992.
• Erdoğan G, Kamerl N, Başkal N, et al. Klinik Endokrinoloji. Antıp AŞ, Ankara, 1997: 67-118.
• Mettler FA, Guiberteau MJ. Essentials of nuclear medicine imaging, Fifth ed. WB Saunders Company, Philadelphia, 2005.
• Freitas JE, Gross MD, Sarkar S. Laboratory (in vitro) assesment of thyroid function. Diagnostic Nuclear Medicine, Sandler MP, Coleman RE, Patton JP, Wackers FJ, Gottschalk A. Fourth ed. Vol. I, 591-606, Lippincott Williams and Wilkins, Philadelphia, 2003.
• Orgiazzi J. Anti-TSH receptor antibodies in clinical practice. Endocrinol Metab Clin North Am 2000; 29: 339-vii.
• Martin WH, Sandler P. Thyroid imaging. diagnostic nuclear medicine, Sandler MP, Coleman RE, Patton JP, Wackers FJ, Gottschalk A. Fourth ed. Vol. I, 607-51, Lippincott Williams and Wilkins, Philadelphia, 2003.
• Sostre S, Parikh S. A visual index of thyroid function. Clin Nucl Med 1979; 4: 59-63.
• Burke G, Halko A, Silverstein GE, Hilligoss M. Comparative thyroid uptake studies with 131 I and 99m TcO 4. J Clin Endocrinol Metab 1972; 34: 630-7.
• Higgins HP, Ball D, Eastham S. 20-min 99m Tc thyroid uptake: a simplified method using the gamma camera. J Nuc Med 1973; 14: 907-11.
• Garra BS. “Elastography: current status, future prospects, and making it work for you,” Ultrasound Quarterly 2011; 27: 177–86.
• Bojunga J, Dauth N, Berner C, et al. Acoustic radiation force impulse imaging for differentiation of thyroid nodules. PLoS One 2012; 7: e42735.
• Grazhdani H, Cantisani V, Lodise P, et al. Prospective evaluation of acoustic radiation force impulse technology in the differentiation of thyroid nodules: accuracy and interobserver variability assessment. J Ultrasound 2014; 17: 13–20.
• Sporea I, Sirli R, Bota S, Vlad M, Popescu A, Zosin I. ARFI elastography for the evaluation of diffuse thyroid gland pathology: Preliminary results. World J Radiol 2012; 4: 174–8.
• Sporea I, Vlad M, Bota S, et al. Thyroid stiffness assessment by acoustic radiation force impulse elastography (ARFI). Ultraschall in der Medizin 2011; 32: 281–5.
• FK Rahatlı, H Turnaoğlu, NG Kırnap, et al. Value of shear wave elastography by virtual touch tissue imaging quantification in patients with diffuse thyroid gland pathology. Turk J Med Sci 2018; 48: 993-8.
• Wee S, Jeon SJ, Choi SS. Iksan-si/KR. Shear wave elastography for the evaluation of diffuse thyroid gland pathology: preliminary results, ECR, poster number; C-0495, 2014.
• Ramos CD, Wittmann DEZ, Etchebehere ECSDC, Tambascia MA, Silva CAM, Camargo EE. Thyroid uptake and scintigraphy using 99mTc pertechnetate: standardization in normal individuals. Sao Paulo Med J/Rev Paul Med 2002; 120: 45-8.
• Stephen C. Duck, J. Sty. Technetium thyroid uptake ratios in pediatric Graves Disease. J Pediatr 1985; 107: 905-9.
• Zuhur S, Ozel A, Kuzu I, et al. The diagnostic utility of color doppler ultrasonography, Tc-99m pertechnetate uptake, and TSH-receptor antibody for differential diagnosis of graves' disease and silent thyroiditis: a comparative study. Endocr Pract 2014; 20: 310-9.
• Hayashi Y, Tamai H, Fukata S, et al. A long-term clinical, immunological, and histological follow-up study of patients with goitrous chronic lymphatic thyroiditis. J Clin Endocrinol Metab 1985; 61: 1172–8.
• Jackson IMD, Hennessey JV, Thyroiditis. In: Becker KL, editors. Principles and practice of endocrinology and metabolism. Third edition. Lippincott Williams & Wilkins. 2001; 456-8.
• Wang C, Crapo LM. The epidemiology of thyroid disease and implications for screening. Endocrinol Metab Clin North Am 1997; 26: 189- 218.
• Tunbridge WM, Vanderpump MP. Population screening for autoimmune thyroid disease. Endocrinol Metab Clin North Am 2000; 29: 239- 53.
• O’Donnell AL. Hyperthyroidizm: systemic effects and differential diagnosis. Falk SE Thyroid Disease. 2nd ed. Philadelphia: Lippincott Raven 1997;14: 241-52.
• Hanks JB. Thyroid. Sabiston D.C (ed). Textbook of Surgery. 16th ed. Philadelphia: WB Saunders Comp 2001; 603-28.
• Fukuhara T, Matsuda E, Izawa S, Fujiwara K, Kitano H. Utility of shear wave elastography for diagnosing chronic autoimmune thyroiditis. J Thyroid Res 2015; 164548: 5.
• Menzilcioglu MS, Duymus M, Gungor G, et al. The value of real-time ultrasound elastography in chronic autoimmüne thyroiditis. Br Institute Radiol 2014; 07.
• Magri F, Chytiris S, Capelli V, et al. Shear wave elastography in the diagnosis of thyroid nodules: feasibility in the case of coexistent chronic autoimmune Hashimoto's thyroiditis. Clin Endocrinol 2012; 76: 137–41
• Vlad M, Golu I, Bota S, et al. Real-time shear wave elastography may predict autoimmune thyroid disease. Wiener klinische Wochenschrift 2015; 127: 330-6.
• Kim I, Kim EK, Yoon JH, Son EJ, Moon HJ, Kwak YJ. Diagnostic role of conventional ultrasonography and shearwave elastography in asymptomatic patients with diffuse thyroid disease: initial experience with 57 patients. Yonsei Med J 2014; 55: 247-53.
• Kara T, Ates F, Durmaz MS, et al. Assessment of thyroid gland elasticity with shear-wave elastography in Hashimoto’s thyroiditis patients. J Ultrasound 2020; 23; 543-51.
• Hussein LA, Abdulwahid HM, Kamal AM. The value of ultrasound elastography in diffuse thyroid disease among a sample of Iraqi population. J Med Sci 2021; 9:1647-53.