Predictive value of real-time shear wave elastography combined with serum thyroglobulin in thyroid cancer

To evaluate the diagnostic value of combining real-time shear wave elastography (SWE) with serum thyroglobulin (Tg) in thyroid cancer (TC) and explore its potential for assessing tumor aggressiveness. This retrospective study included 124 patients with TC and 62 with benign thyroid lesions (January 2024–August 2025). Malignant cases were classified as invasive (n = 78) or non-invasive (n = 46) based on capsular involvement, vascular invasion, or lymph node metastasis. All patients underwent SWE and Tg testing. SWE parameters—maximum (Emax), mean (Emean), minimum (Emin) Young’s modulus—and Tg levels were compared. ROC analysis assessed diagnostic performance, while Spearman correlation examined relationships between SWE and Tg. All malignant cases were papillary thyroid carcinoma. Malignant cases had higher SWE parameters and Tg than benign cases (P < 0.05). Invasive tumors showed higher Emax, Emean, and Tg than non-invasive tumors (P < 0.05). The combined SWE–Tg model AUC for malignancy was 0.844; for aggressiveness, 0.744. Tg correlated positively with SWE parameters (P < 0.001). Combining SWE with Tg improved discrimination between TC and benign thyroid nodules in this cohort and may provide auxiliary value for preoperative assessment of invasive features.