Evaluation of ultrasound accuracy in thyroid mass measurement and its impact on 131I treatment for Graves’ disease

BackgroundThyroid mass is crucial for 131I treatment of Graves’ disease (GD). However, the accuracy of ultrasound (US) - based thyroid mass measurement remains controversial.MethodsThis retrospective study included patients who underwent thyroid US and CT scans. The differences correlation, and agre...

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Main Authors: Xiangxiang Li, Xu Han, Nan Liu, Shen Wang, Hongyuan Zheng, Ziyu Ma, Ruiguo Zhang, Qiang Jia, Wei Zheng
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-07-01
Series:Frontiers in Endocrinology
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Online Access:https://www.frontiersin.org/articles/10.3389/fendo.2025.1617229/full
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author Xiangxiang Li
Xu Han
Nan Liu
Shen Wang
Hongyuan Zheng
Ziyu Ma
Ruiguo Zhang
Qiang Jia
Wei Zheng
author_facet Xiangxiang Li
Xu Han
Nan Liu
Shen Wang
Hongyuan Zheng
Ziyu Ma
Ruiguo Zhang
Qiang Jia
Wei Zheng
author_sort Xiangxiang Li
collection DOAJ
description BackgroundThyroid mass is crucial for 131I treatment of Graves’ disease (GD). However, the accuracy of ultrasound (US) - based thyroid mass measurement remains controversial.MethodsThis retrospective study included patients who underwent thyroid US and CT scans. The differences correlation, and agreement in thyroid mass measurements between the two methods were analyzed. Data from GD patients who received their first 131I treatment were collected and evaluated at a 6-month follow-up. Regression analyses identified clinical factors for treatment efficacy and developed a predictive model.ResultsA statistically significant difference was observed in thyroid mass measurements exceeding 20 g between US and CT. (Z = -11.493, P<0.001). Despite a strong correlation between the two methods (r = 0.9809, P=0.001), the average relative error remained substantial (0.19 ± 11.65%). Poor agreement was observed between CT and US (mean bias: 16.65g; ICC = 0.179, p = 0.087). Disease duration, FT4 level, 24 - hour radioactive iodine uptake, 131I dose and thyroid mass were identified as independent risk factors influencing the efficacy of the initial 131I treatment (p<0.05). Based on these factors, a predictive model was developed and evaluated using ROC curves, DCA and CAL. The model demonstrated an AUC of 0.663 (95% CI = 0.631-0.695).ConclusionUS may underestimate the true thyroid mass in large-mass cases; therefore, CT calibration is recommended before initiating 131I treatment. The proposed predictive model provides valuable guidance for optimizing initial 131I treatment in patients with GD.
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spelling doaj-art-dba9dfa9a13d44a19b593db14da2ee552025-07-25T04:10:07ZengFrontiers Media S.A.Frontiers in Endocrinology1664-23922025-07-011610.3389/fendo.2025.16172291617229Evaluation of ultrasound accuracy in thyroid mass measurement and its impact on 131I treatment for Graves’ diseaseXiangxiang LiXu HanNan LiuShen WangHongyuan ZhengZiyu MaRuiguo ZhangQiang JiaWei ZhengBackgroundThyroid mass is crucial for 131I treatment of Graves’ disease (GD). However, the accuracy of ultrasound (US) - based thyroid mass measurement remains controversial.MethodsThis retrospective study included patients who underwent thyroid US and CT scans. The differences correlation, and agreement in thyroid mass measurements between the two methods were analyzed. Data from GD patients who received their first 131I treatment were collected and evaluated at a 6-month follow-up. Regression analyses identified clinical factors for treatment efficacy and developed a predictive model.ResultsA statistically significant difference was observed in thyroid mass measurements exceeding 20 g between US and CT. (Z = -11.493, P<0.001). Despite a strong correlation between the two methods (r = 0.9809, P=0.001), the average relative error remained substantial (0.19 ± 11.65%). Poor agreement was observed between CT and US (mean bias: 16.65g; ICC = 0.179, p = 0.087). Disease duration, FT4 level, 24 - hour radioactive iodine uptake, 131I dose and thyroid mass were identified as independent risk factors influencing the efficacy of the initial 131I treatment (p<0.05). Based on these factors, a predictive model was developed and evaluated using ROC curves, DCA and CAL. The model demonstrated an AUC of 0.663 (95% CI = 0.631-0.695).ConclusionUS may underestimate the true thyroid mass in large-mass cases; therefore, CT calibration is recommended before initiating 131I treatment. The proposed predictive model provides valuable guidance for optimizing initial 131I treatment in patients with GD.https://www.frontiersin.org/articles/10.3389/fendo.2025.1617229/fullGraves’ diseasethyroid mass131I treatment efficacyclinical predictive modelCT calibration
spellingShingle Xiangxiang Li
Xu Han
Nan Liu
Shen Wang
Hongyuan Zheng
Ziyu Ma
Ruiguo Zhang
Qiang Jia
Wei Zheng
Evaluation of ultrasound accuracy in thyroid mass measurement and its impact on 131I treatment for Graves’ disease
Frontiers in Endocrinology
Graves’ disease
thyroid mass
131I treatment efficacy
clinical predictive model
CT calibration
title Evaluation of ultrasound accuracy in thyroid mass measurement and its impact on 131I treatment for Graves’ disease
title_full Evaluation of ultrasound accuracy in thyroid mass measurement and its impact on 131I treatment for Graves’ disease
title_fullStr Evaluation of ultrasound accuracy in thyroid mass measurement and its impact on 131I treatment for Graves’ disease
title_full_unstemmed Evaluation of ultrasound accuracy in thyroid mass measurement and its impact on 131I treatment for Graves’ disease
title_short Evaluation of ultrasound accuracy in thyroid mass measurement and its impact on 131I treatment for Graves’ disease
title_sort evaluation of ultrasound accuracy in thyroid mass measurement and its impact on 131i treatment for graves disease
topic Graves’ disease
thyroid mass
131I treatment efficacy
clinical predictive model
CT calibration
url https://www.frontiersin.org/articles/10.3389/fendo.2025.1617229/full
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