ArticleEuropean thyroid journal2026
Can back-wall cystic figures of thyroid nodules predict benignity?
Article in European thyroid journal, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
2 citing papers in PubMed.
- Response to Letter to the Editor: "Can back-wall cystic figures of thyroid nodules predict benignity?"European thyroid journal · 2026Article
- Back-wall cystic figures are not undoubtedly pathognomonic of benignity: malignant and infectious mimickers in thyroid lesions.European thyroid journal · 2026Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background: According to the European Thyroid Association (ETA) 2023 consensus, hyperechoic spots correspond to different subtypes: comet tail artifacts, back-wall cystic figures (BWCF), and microcalcifications. BWCF are supposed to be in favor of benignity. However, this is not well supported by the existing literature. Objective: To assess whether EU-TIRADS 4 nodules with BWCF have a lower risk of malignancy than those without BWCF. The secondary objective was to compare this risk to that of EU-TIRADS 3 nodules and evaluate indeterminate and benign cytology rates across the three groups. Methods: Four physicians prospectively included 150 thyroid nodules before fine-needle aspiration: 50 EU-TIRADS 4 with BWCF, 50 EU-TIRADS 4 without BWCF, and 50 EU-TIRADS 3. Results: The difference in malignancy risk between EU-TIRADS 4 without BWCF and EU-TIRADS 4 with BWCF was significant (P < 0.001). EU-TIRADS 3 and EU-TIRADS 4 nodules with BWCF were significantly correlated with Bethesda II cytology: 94 and 82%, respectively, compared to 26% in EU-TIRADS 4 nodules without BWCF (P < 0.001). Bethesda III-IV cytology was more frequent in EU-TIRADS 4 nodules without BWCF (62%) than in EU-TIRADS 4 with BWCF (18%) or EU-TIRADS 3 (6%) (P < 0.001). Conclusion: BWCF in EU-TIRADS 4 nodules indicate a low malignancy risk, close to that of EU-TIRADS 3 nodules. These results underline the need to distinguish BWCF from other hyperechoic foci, such as microcalcifications, to improve risk stratification. Recognizing BWCF may allow the use of higher FNA thresholds and should be considered in future guidelines as I-TIRADS.
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