Role of Elastography in the Evaluation of Parathyroid Disease

Abstract

Primary hyperparathyroidism is a prevalent disease of the parathyroid glands and the third most common endocrinopathy, especially among postmenopausal women. Secondary hyperparathyroidism is a compensatory response to hypocalcemic states due to chronic renal disease, vitamin D deficiency and malabsorption syndromes, and other chronic illnesses. Elastography can be an effective tool in localizing and identifying parathyroid lesions, whether it is a parathyroid adenoma or hyperplastic parathyroid secondary to chronic kidney disease, by differentiating between possible parathyroid lesions and thyroid nodules, cervical lymph nodes, or other anatomical structures. No current guidelines recommendations are available and no established general cutoff values on the elasticity of parathyroid lesions. We have conducted several prospective studies on primary and secondary hyperparathyroidism, using ultrasound imaging and elastography, shear wave, and strain elastography to better identify the parathyroid lesions and improve the preoperative localization and diagnostic. The results were encouraging, allowing us to determine cutoff values that are different for lesions from primary hyperparathyroidism and secondary hyperparathyroidism and comparing them with normal thyroid tissue and surrounding muscle tissue.