{"title":"Integrating shear wave elastography into clinical prediction of Graves' disease recurrence: a novel risk scoring system.","authors":"Xiao-Yun Zha, Ze-Hong Xu, Jia-Jia Dong, Liang-Xiao Xie, Peng-Bin Lai, Chang-Shun Wei, Hua-Qiang Zheng, Duo-Bin Huang, Jin-Zhi Wu","doi":"10.3389/fendo.2025.1551983","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>This study aims to evaluate the utility of shear wave elastography (SWE) in predicting the recurrence risk of Graves' disease(GD), to construct a recurrence risk prediction model that integrates SWE and clinical characteristics, and to develop a risk scoring system aimed at enhancing the survival rate of patients with GD following drug treatment and prognosis management.</p><p><strong>Methods: </strong>A prospective cohort study was conducted involving with 169 patients diagnosed with first-episode GD. By analyzing SWE parameters, three-dimensional thyroid volume, TRAb levels, and other clinical indicators, the Cox proportional hazards model was used to construct a recurrence risk prediction model for GD. Bootstrap resampling was employed to verify the model's reliability. A simple recurrence risk scoring system was also developed based on independent risk factors for clinical use.</p><p><strong>Results: </strong>The study identified several factors significantly associated with GD recurrence: age <35 years, a family history of GD, an initial TRAb level≧15 IU/ml, a thyroid volume≧19 cm³, an initial SWE≧2.0 m/s, and a TSH(thyroid stimulating hormone) normalization duration <4 months. Notably, SWE was found to be a strong predictor, with patients exhibiting SWE ≥2.0 m/s having a recurrence risk that is 4.54 times greater than those with lower values. Based on these risk factors, a scoring system was developed with a cutoff of 4 points for recurrence risk, demonstrating a sensitivity of 74% and a specificity of 91.8%. The area under the curve (AUC) of the final model was 0.91, indicating high predictive accuracy.</p><p><strong>Conclusions: </strong>SWE is an independent predictor of recurrence risk in GD. When combined with traditional clinical indicators, it significantly enhances the predictive capability for GD recurrence. The risk score model provides a simple and effective tool for individualized management and optimization of treatment strategies.</p>","PeriodicalId":12447,"journal":{"name":"Frontiers in Endocrinology","volume":"16 ","pages":"1551983"},"PeriodicalIF":3.9000,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11936816/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Frontiers in Endocrinology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.3389/fendo.2025.1551983","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/1/1 0:00:00","PubModel":"eCollection","JCR":"Q2","JCRName":"ENDOCRINOLOGY & METABOLISM","Score":null,"Total":0}
引用次数: 0
Abstract
Objective: This study aims to evaluate the utility of shear wave elastography (SWE) in predicting the recurrence risk of Graves' disease(GD), to construct a recurrence risk prediction model that integrates SWE and clinical characteristics, and to develop a risk scoring system aimed at enhancing the survival rate of patients with GD following drug treatment and prognosis management.
Methods: A prospective cohort study was conducted involving with 169 patients diagnosed with first-episode GD. By analyzing SWE parameters, three-dimensional thyroid volume, TRAb levels, and other clinical indicators, the Cox proportional hazards model was used to construct a recurrence risk prediction model for GD. Bootstrap resampling was employed to verify the model's reliability. A simple recurrence risk scoring system was also developed based on independent risk factors for clinical use.
Results: The study identified several factors significantly associated with GD recurrence: age <35 years, a family history of GD, an initial TRAb level≧15 IU/ml, a thyroid volume≧19 cm³, an initial SWE≧2.0 m/s, and a TSH(thyroid stimulating hormone) normalization duration <4 months. Notably, SWE was found to be a strong predictor, with patients exhibiting SWE ≥2.0 m/s having a recurrence risk that is 4.54 times greater than those with lower values. Based on these risk factors, a scoring system was developed with a cutoff of 4 points for recurrence risk, demonstrating a sensitivity of 74% and a specificity of 91.8%. The area under the curve (AUC) of the final model was 0.91, indicating high predictive accuracy.
Conclusions: SWE is an independent predictor of recurrence risk in GD. When combined with traditional clinical indicators, it significantly enhances the predictive capability for GD recurrence. The risk score model provides a simple and effective tool for individualized management and optimization of treatment strategies.
期刊介绍:
Frontiers in Endocrinology is a field journal of the "Frontiers in" journal series.
In today’s world, endocrinology is becoming increasingly important as it underlies many of the challenges societies face - from obesity and diabetes to reproduction, population control and aging. Endocrinology covers a broad field from basic molecular and cellular communication through to clinical care and some of the most crucial public health issues. The journal, thus, welcomes outstanding contributions in any domain of endocrinology.
Frontiers in Endocrinology publishes articles on the most outstanding discoveries across a wide research spectrum of Endocrinology. The mission of Frontiers in Endocrinology is to bring all relevant Endocrinology areas together on a single platform.