title: Shear wave elastography and parathyroid adenoma: A new tool for diagnosing parathyroid adenomas.
abstract: OBJECTIVE
  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: Wilmington Endocrinology, 1717 Shipyard Boulevard, Wilmington, NC 28403, United States. Electronic address: azizi@wilmingonendo.com.
authors: Ghobad
authors: G
authors: Azizi
authors: Beth Israel Deaconess Medical Center 109 Brookline Avenue, Suite 200, Boston, MA 02215, United States. Electronic address: kpiper@bidmc.harvard.edu.
authors: Kelé
authors: K
authors: Piper
authors: Wilmington Pathology Associates 1915 South 17th Street, Suite 100 Wilmington, NC 28401, United States. Electronic address: jkwpath@gmail.com.
authors: James M
authors: JM
authors: Keller
authors: Wilmington Endocrinology, 1717 Shipyard Boulevard, Wilmington, NC 28403, United States.
authors: Michelle L
authors: ML
authors: Mayo
authors: Carolina Arthritis 1710 South 17th Street, Wilmington, NC 28401, United States. Electronic address: puett@carolinaarthritis.com.
authors: David
authors: D
authors: Puett
authors: Wilmington Endocrinology, 1717 Shipyard Boulevard, Wilmington, NC 28403, United States.
authors: Karly M
authors: KM
authors: Earp
authors: University of Connecticut Health Center263 Farmington Avenue, Farmington, CT 06030, United States. Electronic address: malchoff@nso2.uchc.edu.
authors: Carl D
authors: CD
authors: Malchoff
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D054459:Elasticity Imaging Techniques / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010280:Parathyroid Glands / Q000000981:diagnostic imaging*; D010282:Parathyroid Neoplasms / Q000150:complications / Q000000981:diagnostic imaging*; D011446:Prospective Studies; D015203:Reproducibility of Results; D055815:Young Adult
keywords: Elastography; Hyperparathyroidism; MIBI Scan; Parathyroid adenoma; Polar vessel sign; Shear wave elastography