{
  "abstract": "Solid-predominant partially cystic thyroid nodules (PCTNs) present challenges for malignancy risk stratification and fine-needle aspiration (FNA) decision-making. This study aimed to compare a multiparametric ultrasound model integrating conventional ultrasound and strain elastography with the American College of Radiology Thyroid Imaging Reporting and Data System (ACR TI-RADS) management strategy for reducing unnecessary FNA in solid-predominant PCTNs. This multicenter retrospective study included solid-predominant PCTNs evaluated at three tertiary referral hospitals between October 2018 and May 2024. A total of 375 nodules were included, with 264 assigned to the training cohort and 111 to the validation cohort. Two predictive models were constructed: Model 1 incorporated maximum nodule diameter and conventional ultrasound features, and Model 2 additionally included elastography. Model performance was evaluated using the area under the receiver operating characteristic curve (AUC), calibration curves, and decision curve analysis. Among the 375 included nodules, 198 (52.8%) were malignant. In the validation cohort, the AUCs were 0.63 [95% confidence interval (CI): 0.54-0.73] for the ACR TI-RADS management strategy, 0.80 (95% CI: 0.72-0.88) for Model 1, and 0.86 (95% CI: 0.78-0.93) for Model 2. Using the continuous ACR TI-RADS score, Model 2 achieved a higher AUC (0.86 vs. 0.74; paired DeLong P=0.02). Elastographic stiffness was the strongest predictor of malignancy in Model 2 [odds ratio (OR), 10.53; 95% CI: 3.65-30.38; P<0.001]. At a threshold probability of 0.62 and relative to the hypothetical strategy of performing FNA for all nodules, Model 2 could potentially avoid 56% of FNAs while missing 27% of malignant nodules, compared with 41% and 27%, respectively, under the ACR TI-RADS management strategy. The combination of conventional ultrasound features and strain elastography outperformed the ACR TI-RADS system for FNA triage in solid-predominant PCTNs and may help reduce unnecessary FNA procedures.",
  "abstract_shown": true,
  "affiliations": [
    "Medical College, Yangzhou University, Yangzhou, China.",
    "Department of Ultrasound, Affiliated Hospital of Integrated Traditional Chinese and Western Medicine, Nanjing University of Chinese Medicine, Nanjing, China.",
    "Department of Ultrasound, Nanjing Lishui District Hospital of Traditional Chinese Medicine, Nanjing, China.",
    "Department of Ultrasound, Northern Jiangsu People's Hospital Affiliated to Yangzhou University, Yangzhou, China.",
    "Department of Ultrasound, Northern Jiangsu People's Hospital, Yangzhou, China.",
    "Jianhu Clinical Medical College of Yangzhou University, Yancheng, China."
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 7,
  "authors": [
    {
      "affs": [
        0,
        1,
        2
      ],
      "name": "Yuguo Wang"
    },
    {
      "affs": [
        0,
        3,
        4
      ],
      "name": "Wangxing Huang"
    },
    {
      "affs": [
        5
      ],
      "name": "Hanzhong Qi"
    },
    {
      "affs": [
        0,
        3,
        4
      ],
      "name": "Huajiao Zhao"
    },
    {
      "affs": [
        4
      ],
      "name": "Cuirong Li"
    },
    {
      "affs": [
        4
      ],
      "name": "Xusheng Song"
    },
    {
      "affs": [
        0,
        3,
        4
      ],
      "name": "Xiaoqin Qian"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/365666ezgxxex.bib",
  "cited_by": 0,
  "doi": "10.21037/gs-2026-0332",
  "fulltext_url": "https://europepmc.org/articles/PMC13740545",
  "id": "365666ezgxxex",
  "issns": [
    "2227-684X",
    "2227-8575"
  ],
  "landing_url": "https://europepmc.org/article/MED/42996834",
  "language": "eng",
  "licence": "CC-BY-NC-ND",
  "licence_label": "CC BY-NC-ND",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by-nc-nd/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "openalex",
      "2712|Thyroid Cancer Diagnosis and Treatment"
    ]
  ],
  "openalex": "W7223889927",
  "pdf_url": "https://europepmc.org/articles/PMC13740545?pdf=render",
  "pmcid": "PMC13740545",
  "pmid": "42996834",
  "published": "2026-10-19",
  "publisher": null,
  "ris": "https://research.draconitic.com/paper/365666ezgxxex.ris",
  "sources": [
    {
      "first_seen": "2026-11-09T15:20:41Z",
      "native_id": "MED:42996834",
      "source": "europepmc",
      "url": "https://europepmc.org/article/MED/42996834"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2712|Thyroid Cancer Diagnosis and Treatment",
      "subfield": "endocrinology-metabolism"
    }
  ],
  "title": "Comparison of a model combining conventional ultrasonography and strain elastography with ACR TI-RADS for reducing unnecessary fine-needle aspiration in solid-predominant partially cystic thyroid nodules: a multicenter study.",
  "title_text": "Comparison of a model combining conventional ultrasonography and strain elastography with ACR TI-RADS for reducing unnecessary fine-needle aspiration in solid-predominant partially cystic thyroid nodules: a multicenter study.",
  "type": "peer-reviewed",
  "updated_at": "2026-11-09T15:20:41Z",
  "url": "https://research.draconitic.com/paper/365666ezgxxex",
  "venue": "Gland surgery",
  "versions": []
}