Ghobad Azizi1, Kelé Piper2, James M Keller3, Michelle L Mayo4, David Puett5, Karly M Earp4, Carl D Malchoff6. 1. Wilmington Endocrinology, 1717 Shipyard Boulevard, Wilmington, NC 28403, United States. Electronic address: azizi@wilmingonendo.com. 2. Beth Israel Deaconess Medical Center 109 Brookline Avenue, Suite 200, Boston, MA 02215, United States. Electronic address: kpiper@bidmc.harvard.edu. 3. Wilmington Pathology Associates 1915 South 17th Street, Suite 100 Wilmington, NC 28401, United States. Electronic address: jkwpath@gmail.com. 4. Wilmington Endocrinology, 1717 Shipyard Boulevard, Wilmington, NC 28403, United States. 5. Carolina Arthritis 1710 South 17th Street, Wilmington, NC 28401, United States. Electronic address: puett@carolinaarthritis.com. 6. University of Connecticut Health Center263 Farmington Avenue, Farmington, CT 06030, United States. Electronic address: malchoff@nso2.uchc.edu.
Abstract
OBJECTIVES: This study prospectively determines the shear wave elastography characteristics of parathyroid adenomas using virtual touch imaging quantification, a non-invasive ultrasound based shear wave elastography method. METHODS: This prospective study examined 57 consecutive patients with biochemically proven primary hyperparathyroidism and solitary parathyroid adenoma identified by ultrasound and confirmed by at least one of the following: surgical resection, positive Technetium-99m Sestamibi Scintigraphy (MIBI) scan, or fine needle aspiration biopsy with positive PTH washout (performed only in MIBI negative patients). Vascularity and shear wave elastography were performed for all patients. Parathyroid adenoma stiffness was measured as shear wave velocity in meters per second. RESULTS: The median (range) pre-surgical value for PTH and calcium were 58pg/mL (19, 427) and 10.8mg/dL (9.5, 12.1), respectively. 37 patients had positive MIBI scan. 20 patients had negative MIBI scan but diagnosis was confirmed with positive PTH washout. 42 patients underwent parathyroidectomy, and an adenoma was confirmed in all. The median (range) shear wave velocity for all parathyroid adenomas enrolled in this study was 2.02m/s (1.53, 2.50). The median (range) shear wave velocity for thyroid tissue was 2.77m/s (1.89, 3.70). The shear wave velocity of the adenomas was independent of adenoma size, serum parathyroid hormone concentration, or plasma parathyroid hormone concentration. CONCLUSIONS: Tissue elasticity of parathyroid adenoma is significantly lower than thyroid tissue. B-mode features and distinct vascularity pattern are helpful tools in diagnosing parathyroid adenoma with ultrasound. Shear wave elastography may provide valuable information in diagnosing parathyroid adenoma.
OBJECTIVES: This study prospectively determines the shear wave elastography characteristics of parathyroid adenomas using virtual touch imaging quantification, a non-invasive ultrasound based shear wave elastography method. METHODS: This prospective study examined 57 consecutive patients with biochemically proven primary hyperparathyroidism and solitary parathyroid adenoma identified by ultrasound and confirmed by at least one of the following: surgical resection, positive Technetium-99m Sestamibi Scintigraphy (MIBI) scan, or fine needle aspiration biopsy with positive PTH washout (performed only in MIBI negative patients). Vascularity and shear wave elastography were performed for all patients. Parathyroid adenoma stiffness was measured as shear wave velocity in meters per second. RESULTS: The median (range) pre-surgical value for PTH and calcium were 58pg/mL (19, 427) and 10.8mg/dL (9.5, 12.1), respectively. 37 patients had positive MIBI scan. 20 patients had negative MIBI scan but diagnosis was confirmed with positive PTH washout. 42 patients underwent parathyroidectomy, and an adenoma was confirmed in all. The median (range) shear wave velocity for all parathyroid adenomas enrolled in this study was 2.02m/s (1.53, 2.50). The median (range) shear wave velocity for thyroid tissue was 2.77m/s (1.89, 3.70). The shear wave velocity of the adenomas was independent of adenoma size, serum parathyroid hormone concentration, or plasma parathyroid hormone concentration. CONCLUSIONS: Tissue elasticity of parathyroid adenoma is significantly lower than thyroid tissue. B-mode features and distinct vascularity pattern are helpful tools in diagnosing parathyroid adenoma with ultrasound. Shear wave elastography may provide valuable information in diagnosing parathyroid adenoma.
Authors: Laura Cotoi; Daniela Amzar; Ioan Sporea; Andreea Borlea; Dan Navolan; Flore Varcus; Dana Stoian Journal: Int J Endocrinol Date: 2020-03-17 Impact factor: 3.257
Authors: Jacek Baj; Robert Sitarz; Marek Łokaj; Alicja Forma; Marcin Czeczelewski; Amr Maani; Gabriella Garruti Journal: Molecules Date: 2020-04-09 Impact factor: 4.411