Evidence map›Paper›PMID 40900268›Full record

ArticleEuropean radiology2026

The role of microflow patterns combined with greyscale ultrasound in enhancing diagnostic validity and reducing unnecessary biopsy rate of thyroid nodules.

Wanying Li, Luying Gao, Yahong Wang, Min Zhang, Yiyan Du, Hongyan Wang, Jianchu Li

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Article in European radiology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

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2 citing papers in PubMed.

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4 · The record

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5 · Who and what money

Authors and funding

7 authors.

Wanying LiDepartment of Ultrasound, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
Luying GaoDepartment of Ultrasound, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
Yahong WangDepartment of Ultrasound, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
Min ZhangDepartment of Ultrasound, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
Yiyan DuDepartment of Ultrasound, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
Hongyan WangDepartment of Ultrasound, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China. whychina@126.com.ORCID http://orcid.org/0000-0003-2710-8698
Jianchu LiDepartment of Ultrasound, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China. jianchu.li@163.com.

Funding

Fundamental Research Funds for the Central Universities 3332023011National High Level Hospital Clinical Research Funding 2022-PUMCH-B-064
6 · The paper itself

Abstract

objectiveTo explore the value of microflow patterns based on superb microvascular imaging (SMI) combined with greyscale ultrasound in thyroid nodule diagnosis and biopsy recommendation. MATERIALS AND

methodsAdult patients with thyroid nodules were recruited from May 2023 to February 2024. The greyscale features of nodules were evaluated according to the five ultrasound risk stratification systems (RSSs). The microflow patterns on SMI were used to adjust the category of nodules. The crab claw-like and the root hair-like patterns were malignant signs for upgrading, with the wheel-like and the arborescent patterns for downgrading. The diagnostic performance and biopsy recommendation of microflow patterns combined with greyscale ultrasound were analyzed.

resultsA total of 253 nodules (136 malignant, 117 benign) in 203 patients were included. Chinese Thyroid Imaging Reporting and Data System (C-TIRADS) owned the best diagnostic sensitivity and the largest AUC, with no significant improvement for the former (0.853 vs 0.904, p = 0.096) but an evident increase for the latter (0.834 vs 0.900, p < 0.001) when combined with SMI. American College of Radiology (ACR) TI-RADS had the highest specificity, which was further enhanced by SMI (0.803 vs 0.855, p = 0.041). The unnecessary biopsy rates of RSSs were reduced by 1.27-20.30% according to microflow patterns on SMI. Among these, C-TIRADS had the lowest unnecessary biopsy rate and the largest reduction after the adjustment by SMI (38.04% vs 17.74%).

conclusionThe microflow patterns on SMI could enhance the diagnostic validity of greyscale ultrasound for thyroid nodules. Besides, the unnecessary biopsy rate could also be decreased by combining with SMI. KEY POINTS: Question The utility of combining superb microvascular imaging (SMI) with greyscale ultrasound for the diagnosis of thyroid nodules and the recommendation of biopsies remains unclear. Findings Risk stratification systems adjusted by microflow patterns on SMI outperformed the original systems in distinguishing thyroid carcinoma and recommending biopsies. Clinical relevance Microflow patterns combined with greyscale ultrasound can enhance the diagnostic validity and reduce the unnecessary biopsy rate for thyroid nodules.

Indexed as

MicrovesselsThyroid NoduleUnnecessary ProceduresAdultAgedFemaleHumansMaleMiddle AgedReproducibility of ResultsRetrospective StudiesSensitivity and SpecificityUltrasonographyDiagnostic performanceSuperb microvascular imagingThyroid noduleUltrasoundUnnecessary biopsy rate

Identifiers

PMID40900268
PMCPMC12963240

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