Shear wave elastography (SWE) and serum thyroglobulin (Tg) as a predictor in the assessment of radioactive iodine treatment in patients with thyroid cancer

Background: Postoperative treatment in the case of differentiated thyroid cancer (DTC) may include radioactive iodine (RAI) treatment, but the optimal level of RAI to be administered needs to be determined properly. Elements such as shear wave elastography (SWE), serum thyroglobulin (Tg), and the association between levothyroxine treatment and several RAI-associated parameters need to be considered properly. Objective: In patients with association of tissue stiffness after thyroidectomy, this prospective observational study aimed to assess whether tissue stiffness and thyroglobulin (Tg) levels are associated with?administered RAI activity. The secondary objective was to evaluate the association of levothyroxine use at the time?of RAI and RAI uptake characteristics, but it did not imply causation. Methods: A total of 100 patients with DTC who received thyroidectomy from?January 2023 to June 2025 were enrolled. Results of pre-RAI shear wave elastography (SWE), Tg levels and levothyroxine therapy?were measured. The RAI activity (mCi) were calculated using the?clinical judgment and analyzed the correlation between SWE, Tg, levothyroxine use, and the RAI parameters. Results: A prospective observational study of 100 DTC patients undergoing thyroidectomy between January 2023 and June 2025 was conducted and analyzed. SWE results and thyroglobulin levels are collected pre-RAI treatment, and the use of levothyroxine is documented. The mCi of RAI is determined based on clinical assessment rather than a standardized method, and the relationship between SWE, thyroglobulin levels, levothyroxine treatment, and the elements of RAI treatment is analyzed. Conclusion: In this group, SWE-derived tissue stiffness and serum levels of thyroglobulin were found to correlate positively with RAI activity administered, in all likelihood related to the underlying tumor characteristics, thus SWE and Tg may be viewed as having possible utility as adjunct markers used in the selection of RAI activity, while there is no evidence to confirm or deny the relationship between levothyroxine usage and RAI uptake.