Prognostic value of acoustic structure quantification in patients with Hashimoto’s thyroiditis

  • Ji Ye Lee
  • Hyun Sook HongEmail author
  • Chul-Hee Kim



Assessment of thyroid parenchymal echogenicity on ultrasonography is a predictor of future thyroid dysfunction. Our objective was to determine the prognostic value of acoustic structure quantification (ASQ) to predict the outcome of patients with Hashimoto’s thyroiditis (HT).

Materials and methods

We prospectively evaluated 90 patients with HT using ASQ from May to December 2013. Surveillance for the development of overt hypothyroidism was conducted over a median period of 40 months (3–55). ASQ were dichotomized based on optimal cutoff values obtained from ROC curve analysis. The probability of developing overt hypothyroidism was compared between the dichotomized subgroups using Kaplan–Meier analysis and log-rank tests. Multivariate Cox regression analysis was performed to determine significant prognostic factors.


The cumulative rate of overt hypothyroidism was 67.7%. The median interval to overt hypothyroidism was 27.9 months (95% confidence interval, 12.0–38.0 months). There was no significant difference in the risk of overt hypothyroidism using qualitative echogenicity between groups (p = 0.669) according to Kaplan–Meier analysis. However, the ASQ average (p < 0.001), standard deviation (p = 0.015), and focal disturbance ratio (p < 0.001) were significantly associated with an increased risk of overt hypothyroidism. Multivariate Cox regression analysis revealed that a higher ASQ average (hazard ratio, 1.03; p = 0.03) and higher thyroid-stimulating hormone level (hazard ratio, 1.02; p = 0.02) were independent predictors of overt hypothyroidism.


ASQ has potential as a prognostic biomarker for predicting the risk of overt hypothyroidism in patients with HT.

Key Points

• ASQ provides quantitative prognostic information of thyroid parenchymal echogenicity.

• ASQ parameters improved the stratification of patients who are prone to develop overt hypothyroidism in HT.

• ASQ can serve as prognostic biomarker in HT.


Thyroiditis, lymphocytic Autoimmune thyroiditis Thyroiditis Hypothyroidism Ultrasonography 



Acoustic structure quantification


Focal disturbance


Hashimoto’s thyroiditis


Standard deviation






Thyroid-stimulating hormone





This research was supported by the Soonchunhyang University Research Fund.

Compliance with ethical standards


The scientific guarantor of this publication is Hyun Sook Hong.

Conflict of interest

The authors declare that they have no conflict of interest.

Statistics and biometry

No complex statistical methods were necessary for this paper.

Informed consent

All adult participants provided written informed consent to participate in this study.

Ethical approval

Institutional Review Board approval was obtained.

Study subjects or cohorts overlap

We disclose that 70 patients in the current study participated in our previous study by Park et al [22]. The previous study dealt with ASQ imaging in terms of differentiating patients with thyroiditis from normal subjects. In this study, those patients were followed up for 5 years, and the prognostic utility of ASQ was investigated.


• prospective

• Diagnostic or prognostic study

• performed at one institution

Supplementary material

330_2019_6174_MOESM1_ESM.docx (22 kb)
ESM 1 (DOCX 22 kb)


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Copyright information

© European Society of Radiology 2019

Authors and Affiliations

  1. 1.Department of RadiologySoonchunhyang University Bucheon HospitalBucheonSouth Korea
  2. 2.Department of Radiology, Eulji Medical CenterEulji University College of MedicineSeoulSouth Korea
  3. 3.Division of Endocrinology and Metabolism, Department of Internal MedicineSoonchunhyang University Bucheon HospitalBucheonSouth Korea

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