{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T01:02:42Z","timestamp":1789520562777,"version":"build-2803163510"},"reference-count":40,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,4,16]],"date-time":"2026-04-16T00:00:00Z","timestamp":1776297600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100003402","name":"Fundaci\u00f3n Valle del Lili","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100003402","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Endocrinol."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Graves\u2019 disease (GD) and silent thyroiditis (ST) are common etiologies of thyrotoxicosis requiring optimal diagnosis to provide different therapeutic approach. Here we compare the diagnostic performance of color Doppler thyroid ultrasound (CDU) with measurement of thyroid artery systolic velocities, thyroid scintigraphy with Tc99 and anti-thyroid-stimulating hormone receptor antibodies (TRABs) to differentiate GD from ST in a tertiary center in Cali, Colombia, between 2022-2024.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This single-center prospective study included 78 adult patients diagnosed with thyrotoxicosis between January 2022 and October 2024. Participants had available information on medical records, thyroid function tests, thyroid peroxidase antibodies, TRABs, CDU and, thyroid scintigraphy at the time of diagnosis. Data analysis was performed in October 2024 and determined area under the curve, sensitivity, and specificity of CDU and scintigraphy for differentiating GD from ST, and the performance of each measured parameter were determined.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>78 patients were included, 63% were diagnosed with Graves\u2019 disease, and 37% with thyroiditis. 28\/29 patients with thyroiditis (96.6%) had superior thyroid artery systolic velocities (STV) &amp;lt; 43 cm\/s and 25\/29 of cases (86.2%) had thyroid tissue blood flow (TBF) &amp;lt; 14.1%. The presence of a diffusely increased pattern + percentage of trapping higher than 4.9% in scintigraphy had a sensitivity of 80% and a specificity of 90% for the diagnosis of GD.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>CDU of the thyroid arteries with measurement of systolic velocities is a useful diagnostic tool for differentiating between GD and ST. A cut-off point of STV &amp;lt; 43 cm\/s has a high positive predictive value for ST diagnosis.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fendo.2026.1748502","type":"journal-article","created":{"date-parts":[[2026,4,16]],"date-time":"2026-04-16T04:20:33Z","timestamp":1776313233000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Use of color Doppler ultrasound to differentiate Graves\u2019 disease from silent thyroiditis in patients treated at Fundaci\u00f3n Valle del Lili in 2022-2024"],"prefix":"10.3389","volume":"17","author":[{"given":"Mar\u00eda Bernarda","family":"Iriarte Dur\u00e1n","sequence":"first","affiliation":[{"name":"Facultad de Salud, Departamento de Medicina, Universidad Icesi","place":["Cali, Colombia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Oriana","family":"Arias Valderrama","sequence":"additional","affiliation":[{"name":"Facultad de Salud, Departamento de Medicina, Universidad Icesi","place":["Cali, Colombia"]},{"name":"Centro de Investigaciones Cl\u00ednicas, Fundaci\u00f3n Valle del Lili","place":["Cali, Colombia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francisco Javier","family":"Meza D\u00edaz","sequence":"additional","affiliation":[{"name":"Centro de Investigaciones Cl\u00ednicas, Fundaci\u00f3n Valle del Lili","place":["Cali, Colombia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mayra Alejandra","family":"Rojas Ramirez","sequence":"additional","affiliation":[{"name":"Facultad de Salud, Departamento de Medicina, Universidad Icesi","place":["Cali, Colombia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mar\u00eda Ang\u00e9lica","family":"Guerra Soto","sequence":"additional","affiliation":[{"name":"Centro de Investigaciones Cl\u00ednicas, Fundaci\u00f3n Valle del Lili","place":["Cali, Colombia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andr\u00e9s Octavio","family":"Garc\u00eda-Trujillo","sequence":"additional","affiliation":[{"name":"Facultad de Salud, Departamento de Medicina, Universidad Icesi","place":["Cali, Colombia"]},{"name":"Fundaci\u00f3n Valle del Lili, Departamento de Medicina Interna, Servicio de Endocrinolog\u00eda","place":["Cali, Colombia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Flor Mar\u00eda","family":"Medina","sequence":"additional","affiliation":[{"name":"Fundaci\u00f3n Valle del Lili, Servicio de Radiolog\u00eda e Im\u00e1genes Diagn\u00f3sticas Carrea","place":["Cali, Colombia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luz \u00c1ngela","family":"Casas-Figueroa","sequence":"additional","affiliation":[{"name":"Facultad de Salud, Departamento de Medicina, Universidad Icesi","place":["Cali, Colombia"]},{"name":"Fundaci\u00f3n Valle del Lili, Departamento de Medicina Interna, Servicio de Endocrinolog\u00eda","place":["Cali, Colombia"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,4,16]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.1038\/nrendo.2018.18","article-title":"Global epidemiology of hyperthyroidism and hypothyroidism","volume":"14","author":"Taylor","year":"2018","journal-title":"Nat Rev Endocrinol"},{"key":"B2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(23)02016-0","article-title":"Hyperthyroidism","volume":"403","author":"Chaker","year":"2024","journal-title":"Lancet"},{"key":"B3","doi-asserted-by":"publisher","DOI":"10.1159\/000490384","article-title":"2018 European Thyroid Association Guideline for the Management of Graves' Hyperthyroidism","volume":"7","author":"Kahaly","year":"2018","journal-title":"Eur Thyroid J"},{"key":"B4","doi-asserted-by":"publisher","DOI":"10.1016\/j.mayocp.2018.10.011","article-title":"Thyrotoxicosis: Diagnosis and Management","volume":"94","author":"Sharma","year":"2019","journal-title":"Mayo Clin Proc"},{"key":"B5","doi-asserted-by":"publisher","DOI":"10.1089\/thy.2016.0229","article-title":"2016 American Thyroid Association Guidelines for Diagnosis and Management of Hyperthyroidism and Other Causes of Thyrotoxicosis","volume":"26","author":"Ross","year":"2016","journal-title":"Thyroid"},{"key":"B6","doi-asserted-by":"publisher","DOI":"10.1186\/s12902-019-0388-x","article-title":"Mean peak systolic velocity of superior thyroid artery for the differential diagnosis of thyrotoxicosis: a diagnostic meta-analysis","volume":"19","author":"Peng","year":"2019","journal-title":"BMC Endocr Disord"},{"key":"B7","doi-asserted-by":"publisher","DOI":"10.1159\/000350560","article-title":"Use of color Doppler ultrasonography to measure thyroid blood flow and differentiate graves' disease from painless thyroiditis","volume":"2","author":"Hiraiwa","year":"2013","journal-title":"Eur Thyroid J"},{"key":"B8","doi-asserted-by":"publisher","DOI":"10.20945\/2359-3997000000165","article-title":"Comparison between peak systolic velocity of the inferior thyroid artery and technetium-99m pertechnetate thyroid uptake in differentiating Graves' disease from thyroiditis","volume":"63","author":"Malik","year":"2019","journal-title":"Arch Endocrinol Metab"},{"key":"B9","doi-asserted-by":"publisher","DOI":"10.4158\/EP13300.OR","article-title":"The Diagnostic Utility of Color Doppler Ultrasonography, Tc-99m Pertechnetate Uptake, and TSH-Receptor Antibody for Differential Diagnosis of Graves' Disease and Silent Thyroiditis: A Comparative Study","volume":"20","author":"Zuhur","year":"2014","journal-title":"Endocr Pract"},{"key":"B10","doi-asserted-by":"publisher","DOI":"10.1055\/s-0033-1363282","article-title":"Color flow Doppler sonography for the etiologic diagnosis of thyrotoxicosis","volume":"46","author":"Rosario","year":"2014","journal-title":"Horm Metab Res"},{"key":"B11","doi-asserted-by":"publisher","DOI":"10.1080\/17446651.2022.2052044","article-title":"Management of Graves' hyperthyroidism: present and future","volume":"17","author":"Bartalena","year":"2022","journal-title":"Expert Rev Endocrinol Metab"},{"key":"B12","doi-asserted-by":"publisher","DOI":"10.3389\/fendo.2024.1393126","article-title":"A meta-analysis: elucidating diagnostic thresholds of peak systolic flow velocities in thyroid arteries for the discrimination of Graves' disease and destructive thyrotoxicosis","volume":"15","author":"Li","year":"2024","journal-title":"Front Endocrinol (Lausanne)"},{"key":"B13","doi-asserted-by":"publisher","DOI":"10.53853\/encr.8.2.709","article-title":"Patrones de pr\u00e1ctica cl\u00ednica en la enfermedad de Graves en Colombia","volume":"8","author":"Perdomo-Parrado","year":"2021","journal-title":"Rev Colomb Endocrinol Diabet Metab"},{"key":"B14","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2012-2802","article-title":"A 2011 survey of clinical practice patterns in the management of Graves' disease","volume":"97","author":"Burch","year":"2012","journal-title":"J Clin Endocrinol Metab"},{"key":"B15","doi-asserted-by":"publisher","DOI":"10.1111\/cen.12688","article-title":"A 2013 European survey of clinical practice patterns in the management of Graves' disease","volume":"84","author":"Bartalena","year":"2016","journal-title":"Clin Endocrinol (Oxf)"},{"key":"B16","doi-asserted-by":"publisher","DOI":"10.23736\/S1824-4785.21.03333-1","article-title":"Update on diagnosis and treatment of hyperthyroidism: ultrasonography and functional imaging","volume":"65","author":"Schenke","year":"2021","journal-title":"Q J Nucl Med Mol Imaging"},{"key":"B17","doi-asserted-by":"publisher","DOI":"10.2967\/jnumed.120.243170","article-title":"The Role of Nuclear Medicine in the Clinical Management of Benign Thyroid Disorders, Part 1: Hyperthyroidism","volume":"62","author":"Mariani","year":"2021","journal-title":"J Nucl Med"},{"key":"B18","doi-asserted-by":"publisher","DOI":"10.1089\/thy.2014.0353","article-title":"Thyroid ultrasound features and risk of carcinoma: a systematic review and meta-analysis of observational studies","volume":"25","author":"Remonti","year":"2015","journal-title":"Thyroid"},{"key":"B19","doi-asserted-by":"publisher","DOI":"10.1089\/thy.2018.0085","article-title":"Thyroid Nodules with Indeterminate Cytology: Utility of the American Thyroid Association Sonographic Patterns for Cancer Risk Stratification","volume":"28","author":"Valderrabano","year":"2018","journal-title":"Thyroid"},{"key":"B20","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9149(90)90817-k","article-title":"Effect of beta adrenoceptors and thyroid hormones on velocity and acceleration of peripheral arterial flow in hyperthyroidism","volume":"65","author":"Chemla","year":"1990","journal-title":"Am J Cardiol"},{"key":"B21","doi-asserted-by":"publisher","DOI":"10.4329\/wjr.v5.i4.178","article-title":"Role of color Doppler in differentiation of Graves' disease and thyroiditis in thyrotoxicosis","volume":"5","author":"Donkol","year":"2013","journal-title":"World J Radiol"},{"key":"B22","doi-asserted-by":"publisher","DOI":"10.1016\/j.eprac.2024.02.001","article-title":"Using Bedside Spectral Doppler Ultrasound for the Assessment of Patients With Thyrotoxicosis","volume":"30","author":"Morkos","year":"2024","journal-title":"Endocr Pract"},{"key":"B23","doi-asserted-by":"crossref","first-page":"49","DOI":"10.1007\/978-3-319-44100-9_6","article-title":"Principles of Color and Power Doppler in Neck Ultrasound Imaging","volume-title":"Advanced Thyroid and Parathyroid Ultrasound","author":"Hangiandreou","year":"2017"},{"key":"B24","doi-asserted-by":"publisher","DOI":"10.1007\/s00259-019-04472-8","article-title":"EANM practice guideline\/SNMMI procedure standard for RAIU and thyroid scintigraphy","volume":"46","author":"Giovanella","year":"2019","journal-title":"Eur J Nucl Med Mol Imaging"},{"key":"B25","doi-asserted-by":"publisher","DOI":"10.1038\/nrcardio.2016.174","article-title":"Thyroid hormones and cardiovascular disease","volume":"14","author":"Jabbar","year":"2017","journal-title":"Nat Rev Cardiol"},{"key":"B26","doi-asserted-by":"publisher","DOI":"10.1089\/105072503322238854","article-title":"Hyperthyroidism, bone mineral, and fracture risk--a meta-analysis","volume":"13","author":"Vestergaard","year":"2003","journal-title":"Thyroid"},{"key":"B27","doi-asserted-by":"publisher","DOI":"10.1001\/jama.294.1.71","article-title":"Thyroid function and mortality in patients treated for hyperthyroidism","volume":"294","author":"Franklyn","year":"2005","journal-title":"JAMA"},{"key":"B28","doi-asserted-by":"publisher","DOI":"10.1210\/clinem\/dgae222","article-title":"A 2023 International Survey of Clinical Practice Patterns in the Management of Graves Disease: A Decade of Change","volume":"109","author":"Villagelin","year":"2024","journal-title":"J Clin Endocrinol Metab"},{"key":"B29","doi-asserted-by":"publisher","DOI":"10.1530\/EJE-18-0678","article-title":"ANNIVERSARY REVIEW: Antithyroid drug therapy: 70 years later","volume":"179","author":"Burch","year":"2018","journal-title":"Eur J Endocrinol"},{"key":"B30","doi-asserted-by":"publisher","DOI":"10.1210\/clinem\/dgad538","article-title":"Outcomes of Patients With Graves Disease 25 Years After Initiating Antithyroid Drug Therapy","volume":"109","author":"Meling Stokland","year":"2024","journal-title":"J Clin Endocrinol Metab"},{"key":"B31","doi-asserted-by":"publisher","DOI":"10.7759\/cureus.21339","article-title":"A Case Report on Methimazole-Induced Severe Hypothyroidism","volume":"14","author":"Alaie","year":"2022","journal-title":"Cureus"},{"key":"B32","doi-asserted-by":"publisher","DOI":"10.1159\/000478522","article-title":"Performance and Specificity of 6 Immunoassays for TSH Receptor Antibodies: A Multicenter Study","volume":"6","author":"Diana","year":"2017","journal-title":"Eur Thyroid J"},{"key":"B33","doi-asserted-by":"publisher","DOI":"10.1089\/thy.2006.16.295","article-title":"Serum thyrotropin receptor antibodies concentrations in patients with Graves' disease before, at the end of methimazole treatment, and after drug withdrawal: evidence that the activity of thyrotropin receptor antibody and\/or thyroid response modify during the observation period","volume":"16","author":"Carella","year":"2006","journal-title":"Thyroid"},{"key":"B34","doi-asserted-by":"publisher","DOI":"10.1507\/endocrj.k10e-262","article-title":"Drug discontinuation after treatment with minimum maintenance dose of an antithyroid drug in Graves' disease: a retrospective study on effects of treatment duration with minimum maintenance dose on lasting remission","volume":"58","author":"Konishi","year":"2011","journal-title":"Endocr J"},{"key":"B35","doi-asserted-by":"publisher","DOI":"10.2147\/IJGM.S375016","article-title":"Duplex Hemodynamic Parameters of Both Superior and Inferior Thyroid Arteries in Evaluation of Thyroid Hyperfunction Disorders","volume":"15","author":"Assem Hussein","year":"2022","journal-title":"Int J Gen Med"},{"key":"B36","doi-asserted-by":"publisher","DOI":"10.3390\/diagnostics15040471","article-title":"Establishing Reference Values for Thyroid Vascularity Using Ultra-Micro Angiography (UMA) Ultrasound Technology","volume":"15","author":"Moisa-Luca","year":"2025","journal-title":"Diagnostics (Basel)"},{"key":"B37","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0050051","article-title":"Peak systolic velocity of superior thyroid artery for the differential diagnosis of thyrotoxicosis","volume":"7","author":"Zhao","year":"2012","journal-title":"PLoS One"},{"key":"B38","doi-asserted-by":"publisher","DOI":"10.1055\/s-0041-1734360","article-title":"Diagnostic Utility of Mean Peak Systolic Velocity of Superior Thyroid Artery in Differentiating Graves' Disease from Thyroiditis","volume":"31","author":"Sarangi","year":"2021","journal-title":"Indian J Radiol Imaging"},{"key":"B39","doi-asserted-by":"publisher","DOI":"10.1111\/cen.14069","article-title":"Thyroid nodules as a risk factor for thyroid cancer in patients with Graves' disease: A systematic review and meta-analysis of observational studies in surgically treated patients","volume":"91","author":"Papanastasiou","year":"2019","journal-title":"Clin Endocrinol (Oxf)"},{"key":"B40","article-title":"Thyroid carcinoma risk in patients with hyperthyroidism and role of preoperative cytology in diagnosis","volume":"34","author":"Gul","year":"2009","journal-title":"Minerva Endocrinol"}],"container-title":["Frontiers in Endocrinology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fendo.2026.1748502\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,16]],"date-time":"2026-04-16T04:20:34Z","timestamp":1776313234000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fendo.2026.1748502\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,4,16]]},"references-count":40,"alternative-id":["10.3389\/fendo.2026.1748502"],"URL":"https:\/\/doi.org\/10.3389\/fendo.2026.1748502","relation":{},"ISSN":["1664-2392"],"issn-type":[{"value":"1664-2392","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,4,16]]},"article-number":"1748502"}}