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ORIGINAL RESEARCH article
Front. Oncol.
Sec. Head and Neck Cancer
Volume 15 - 2025 | doi: 10.3389/fonc.2025.1565400
This article is part of the Research Topic Early Diagnosis in Head and Neck Cancer: Advances, Techniques, and Challenges View all 5 articles
Additional diagnostic value of ratio indices of quantitative contrast-enhanced ultrasound parameters in small solid C-TIRADS 4 thyroid nodules
Provisionally accepted- Department of Ultrasound, The Third Xiangya Hospital, Central South University, Changsha, Hunan Province, China
Background: To investigate the efficacy of contrast-enhanced ultrasound (CEUS) parameters, particularly ratio indices of quantitative CEUS parameters, for differentiation of small solid C-TIRADS 4 thyroid nodules.Materials and methods: 235 small solid C-TIRADS 4 thyroid nodules with determinate pathological results, including 175 nodules in the training cohort and 60 nodules in the validation cohort were retrospectively evaluated. The ratio indices of the internal tissue to peripheral tissue and the internal tissue to healthy tissue of quantitative parameters were calculated. In the training cohort, the meaningful quantitative ratio indices with an AUC > 0.7 and qualitative parameters were further included in multivariate regression analysis. The diagnostic efficacy of the logistic model was evaluated.Results: In single-factor analysis, C-TIRADS, enhancement degree, mTTI ratio (L/P), TTP ratio (L/P), WiR ratio (L/P), WoR ratio (L/P) and TTP ratio (L/H) were significant parameters for differentiation of thyroid nodules (P < 0 .05). The multifactor analysis showed that there was significant difference in C-TIRADS, mTTI ratio (L/P), TTP ratio (L/P), WiR ratio (L/P), WoR ratio (L/P) and TTP ratio (L/H) between two groups (P < 0 .05). The logistic model was generated, and the AUC, sensitivity, specificity, and accuracy of the training cohort were 0.935(95% CI: 0.888–0.967),85.71%, 88.57%, and 86.86%, respectively. The logistic model demonstrated significantly higher diagnostic performance compared to individual parameters (P < 0.001). In the validation cohort, the diagnostic model had an AUC of 0.910,sensitivity of 87.9%, specificity of 92.6%, and accuracy of 90.25%.Conclusion: Ratio indices of quantitative parameters have high diagnostic values in differentiating small solid thyroid nodules. Combining C-TIRADS with both qualitative and quantitative CEUS parameters enhances the diagnostic accuracy of malignant thyroid nodules.
Keywords: Contrast-enhanced ultrasound (CEUS), quantitative, Qualitative, Thyroid Nodule, thyroid papillary carcinoma, Chinese thyroid imaging reporting and data system(C-TIRADS)
Received: 23 Jan 2025; Accepted: 31 Mar 2025.
Copyright: © 2025 Xie, Liu, Zhou and Zhou. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Ping Zhou, Department of Ultrasound, The Third Xiangya Hospital, Central South University, Changsha, Hunan Province, China
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