ArticleFrontiers in oncology2026
Diagnostic efficacy of ultrasound combined with fine-needle aspiration biopsy for papillary thyroid carcinoma based on C-TIRADS and ATA guidelines.
Article in Frontiers in oncology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Objective: This study aimed to analyze the diagnostic efficacy of color Doppler ultrasound combined with ultrasound-guided fine-needle aspiration biopsy (US-FNAB) for papillary thyroid carcinoma (PTC) based on the Chinese Thyroid Imaging Reporting and Data System (C-TIRADS) and the guidelines of the American Thyroid Association (ATA). Methods: A total of 478 patients were enrolled from January 2021 to December 2025, with postoperative pathological results as the gold standard. Chi-square test and binary logistic regression were used to identify risk factors. ROC curve analysis was used for diagnostic efficacy, and Kappa test was used separately for consistency. The performance of C-TIRADS and ATA was compared using equivalent malignancy risk thresholds. Results: Logistic regression showed that unclear border, irregular shape, vertical growth, microcalcification, aspect ratio >1, capsular invasion, and lobulated lesions were independent risk factors for PTC (p<0.05). Combined diagnosis achieved higher sensitivity, accuracy, and discriminative power than either single examination. By ROC analysis, the AUC of ultrasound, US-FNAB, and their combination was 0.709, 0.708, and 0.762, respectively. Kappa values showed moderate agreement with pathology. The AUC of C-TIRADS and ATA was 0.708 and 0.669, respectively. C-TIRADS showed significantly higher sensitivity, specificity and accuracy than ATA guidelines (p<0.05). Inter-observer agreement for C-TIRADS and ATA classification was good (κ=0.81, κ=0.77, respectively). Conclusion: Ultrasound combined with US-FNAB yields higher clinical value for PTC diagnosis, especially in indeterminate and discordant cases. C-TIRADS is recommended for routine risk stratification before FNAB in Chinese clinical settings.
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