ESPE Abstracts

Introduction: Shear wave elastography (SWE) is an ultrasound diagnostic method used to measure tissue stiffness. Since the mechanical properties of tissue involved in the pathological process are changed, SWE might indicate regions of the examined tissue covered by the disease. It is well documented, that SWE helps differentiate benign and malignant nodules in thyroid gland in adults, however there are still few studies on application of SWE in thyroid diagnosis in children. The purpose of the study was to assess the application of SWE based on Young's modulus expressed in kPa in the management of thyroid nodules in children and adolescents.

Materials and Methods: 71 pediatric patients (49 girls and 22 boys) with 93 thyroid nodules were enrolled to the study and were qualified to SWE which followed fine needle aspiration biopsy.

Results: In 81 nodules the result of biopsy was benign (II according to Bethesda scale, cytological diagnosis: nodular goitre, parenchymal goitre, nodular colloid goitre or lymphocytic inflammation). In 11 cases the result was III according to Bethesda scale (AUS - Atypia of Undetermined Significance or FLUS - Follicular Lesion of Undetermined Significance in cytology) and 1 nodule was IV according to Bethesda scale (suspected follicular neoplasm - oxyphilic cell tumor). Benign nodules were located in 41% in left lobe, in 53% in right lobe and in 6 % in both lobes. In nodules qualified as III or IV according to Bethesda they were located in 42% in left lobe and in 58 % in right lobe. There were no significant differences between TSH and fT4 concentration between both groups. Patients with benign and suspected thyroid nodules were of comparable age. Mean SWE in benign nodules was lower than in nodules with III and IV according to Bethesda, however this difference was not statistically significant (44.77±18.07 kPa vs. 60.71±29.05 kPa, P=0.0559). Moreover there was a significant correlation between the Bethesda scale and SWE values.

Conclusion: Our results suggest that SWE is a viable diagnostic method however it still seems to need some adjustment for pediatric patients.