The role of elastography in determining the risk of malignant thyroid nodules in children

IntroductionUltrasonography is fundamental method of diagnosing focal thyroid lesions. The additional element of ultrasound examination is Strain Elastography which allows for determining the degree of elasticity of the nodule while comparing it to the surrounding thyroid parenchyma. Pediatric thyro...

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Main Authors: Aleksandra Kiszka-Wiłkojć, Anna Taczanowska-Niemczuk, Dominika Januś, Marcin Maślanka, Joanna Godlewska, Monika Kujdowicz, Michał Wiłkojć, Wojciech Górecki
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Language:English
Published: Frontiers Media S.A. 2024-11-01
Series:Frontiers in Endocrinology
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Online Access:https://www.frontiersin.org/articles/10.3389/fendo.2024.1461031/full
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author Aleksandra Kiszka-Wiłkojć
Aleksandra Kiszka-Wiłkojć
Anna Taczanowska-Niemczuk
Anna Taczanowska-Niemczuk
Dominika Januś
Dominika Januś
Marcin Maślanka
Marcin Maślanka
Joanna Godlewska
Joanna Godlewska
Monika Kujdowicz
Monika Kujdowicz
Michał Wiłkojć
Wojciech Górecki
Wojciech Górecki
author_facet Aleksandra Kiszka-Wiłkojć
Aleksandra Kiszka-Wiłkojć
Anna Taczanowska-Niemczuk
Anna Taczanowska-Niemczuk
Dominika Januś
Dominika Januś
Marcin Maślanka
Marcin Maślanka
Joanna Godlewska
Joanna Godlewska
Monika Kujdowicz
Monika Kujdowicz
Michał Wiłkojć
Wojciech Górecki
Wojciech Górecki
author_sort Aleksandra Kiszka-Wiłkojć
collection DOAJ
description IntroductionUltrasonography is fundamental method of diagnosing focal thyroid lesions. The additional element of ultrasound examination is Strain Elastography which allows for determining the degree of elasticity of the nodule while comparing it to the surrounding thyroid parenchyma. Pediatric thyroid nodules have a higher malignancy risk than in adults, warranting the consideration of fine-needle aspiration biopsy (FNAB) in children.Material and methodsA prospective data analysis of children with focal thyroid lesions treated from 2021 to 2022 was performed. The patients underwent ultrasound and elastography examinations to obtain the Strain Ratio (SR) of the nodules and were qualified for FNAB. SR was determined by the windowing method of relative strains in a semi-quantitative assessment. The FNAB score was determined on the Bethesda scale and the histological examination of the thyroid nodule was performed. The SR values were stratified in three groups: I - thyroid cancer, II - low-risk thyroid tumors, and III - benign lesion. The Kruskal-Wallis test was used to find the relation between the value of SR elastography and the malignancy, with the p value < 0.05 considered significant. The data were analyzed using the multiple comparisons test.ResultsThe 123 FNABs were performed in 100 patients. The final analysis included 119 nodules in 96 patients. In 19 cases, the nodule was malignant, in 5 cases they were low-risk tumors, and in 95 - benign lesions. A difference of the SR value between groups in the pairs of malignant and benign tumors, and malignant and low-risk tumors was revealed. Since no statistically significant difference in the level of elastography was found between benign and low-risk tumors, both groups were combined and formed a group of benign tumors. For the combined groups, the Man-Whitney test was performed, confirming that there was a statistically significant difference between the groups of malignant and benign tumors in the value of SR elastography. The cut-off point for SR for malignant tumors was >3.ConclusionsThe SR index of elastography is significantly higher in malignant nodules. and might be used to select changes with an increased risk of malignancy in thyroid ultrasound of children.
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spelling doaj-art-e2a30f12b5ec46dbb773c73cc5d94d202024-11-15T04:36:47ZengFrontiers Media S.A.Frontiers in Endocrinology1664-23922024-11-011510.3389/fendo.2024.14610311461031The role of elastography in determining the risk of malignant thyroid nodules in childrenAleksandra Kiszka-Wiłkojć0Aleksandra Kiszka-Wiłkojć1Anna Taczanowska-Niemczuk2Anna Taczanowska-Niemczuk3Dominika Januś4Dominika Januś5Marcin Maślanka6Marcin Maślanka7Joanna Godlewska8Joanna Godlewska9Monika Kujdowicz10Monika Kujdowicz11Michał Wiłkojć12Wojciech Górecki13Wojciech Górecki14Department of Pediatric Surgery, Institute of Pediatrics, Jagiellonian University Medical College, Krakow, PolandDepartment of Pediatric Surgery, University Children’s Hospital of Krakow, Krakow, PolandDepartment of Pediatric Surgery, Institute of Pediatrics, Jagiellonian University Medical College, Krakow, PolandDepartment of Pediatric Surgery, University Children’s Hospital of Krakow, Krakow, PolandDepartment of Pediatric and Adolescent Endocrinology, Chair of Pediatrics, Institute of Pediatrics, Jagiellonian University Medical College, Krakow, PolandDepartment of Pediatric and Adolescent Endocrinology, University Children’s Hospital in Krakow, Krakow, PolandDepartment of Pediatric Surgery, Institute of Pediatrics, Jagiellonian University Medical College, Krakow, PolandDepartment of Pediatric Surgery, University Children’s Hospital of Krakow, Krakow, PolandDepartment of Pediatric Surgery, Institute of Pediatrics, Jagiellonian University Medical College, Krakow, PolandDepartment of Pediatric Surgery, University Children’s Hospital of Krakow, Krakow, PolandDepartment of Pathology, University Children’s Hospital of Krakow, Krakow, PolandDepartment of Pathomorphology, Jagiellonian University Medical College, Krakow, PolandDepartment of General, Oncological, Metabolic and Thoracic Surgery, Military Institute of Medicine, National Research Institute, Warsaw, PolandDepartment of Pediatric Surgery, Institute of Pediatrics, Jagiellonian University Medical College, Krakow, PolandDepartment of Pediatric Surgery, University Children’s Hospital of Krakow, Krakow, PolandIntroductionUltrasonography is fundamental method of diagnosing focal thyroid lesions. The additional element of ultrasound examination is Strain Elastography which allows for determining the degree of elasticity of the nodule while comparing it to the surrounding thyroid parenchyma. Pediatric thyroid nodules have a higher malignancy risk than in adults, warranting the consideration of fine-needle aspiration biopsy (FNAB) in children.Material and methodsA prospective data analysis of children with focal thyroid lesions treated from 2021 to 2022 was performed. The patients underwent ultrasound and elastography examinations to obtain the Strain Ratio (SR) of the nodules and were qualified for FNAB. SR was determined by the windowing method of relative strains in a semi-quantitative assessment. The FNAB score was determined on the Bethesda scale and the histological examination of the thyroid nodule was performed. The SR values were stratified in three groups: I - thyroid cancer, II - low-risk thyroid tumors, and III - benign lesion. The Kruskal-Wallis test was used to find the relation between the value of SR elastography and the malignancy, with the p value < 0.05 considered significant. The data were analyzed using the multiple comparisons test.ResultsThe 123 FNABs were performed in 100 patients. The final analysis included 119 nodules in 96 patients. In 19 cases, the nodule was malignant, in 5 cases they were low-risk tumors, and in 95 - benign lesions. A difference of the SR value between groups in the pairs of malignant and benign tumors, and malignant and low-risk tumors was revealed. Since no statistically significant difference in the level of elastography was found between benign and low-risk tumors, both groups were combined and formed a group of benign tumors. For the combined groups, the Man-Whitney test was performed, confirming that there was a statistically significant difference between the groups of malignant and benign tumors in the value of SR elastography. The cut-off point for SR for malignant tumors was >3.ConclusionsThe SR index of elastography is significantly higher in malignant nodules. and might be used to select changes with an increased risk of malignancy in thyroid ultrasound of children.https://www.frontiersin.org/articles/10.3389/fendo.2024.1461031/fullultrasonographythyroid nodulestrain elastographyEU-TIRADSthyroid cancer
spellingShingle Aleksandra Kiszka-Wiłkojć
Aleksandra Kiszka-Wiłkojć
Anna Taczanowska-Niemczuk
Anna Taczanowska-Niemczuk
Dominika Januś
Dominika Januś
Marcin Maślanka
Marcin Maślanka
Joanna Godlewska
Joanna Godlewska
Monika Kujdowicz
Monika Kujdowicz
Michał Wiłkojć
Wojciech Górecki
Wojciech Górecki
The role of elastography in determining the risk of malignant thyroid nodules in children
Frontiers in Endocrinology
ultrasonography
thyroid nodule
strain elastography
EU-TIRADS
thyroid cancer
title The role of elastography in determining the risk of malignant thyroid nodules in children
title_full The role of elastography in determining the risk of malignant thyroid nodules in children
title_fullStr The role of elastography in determining the risk of malignant thyroid nodules in children
title_full_unstemmed The role of elastography in determining the risk of malignant thyroid nodules in children
title_short The role of elastography in determining the risk of malignant thyroid nodules in children
title_sort role of elastography in determining the risk of malignant thyroid nodules in children
topic ultrasonography
thyroid nodule
strain elastography
EU-TIRADS
thyroid cancer
url https://www.frontiersin.org/articles/10.3389/fendo.2024.1461031/full
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