Application value of multimodal ultrasound in differential diagnosis of thyroid nodules

Background: Background: While conventional ultrasound (US) remains the first-line diagnostic tool, its limitations in distinguishing benign from malignant nodules necessitate exploring complementary techniques.This study aimed to evaluate the potential of integrating contrast-enhanced ultrasound (CEUS) and ultrasound elastography (UE) alongside conventional US to improve diagnostic accuracy compared to individual modalities.Materials and Methods: This retrospective analysis was conducted at Tangshan people's Hospital.We enrolled 180 consecutive patients diagnosed with thyroid nodules between January 2021 and December 2022.All participants underwent comprehensive ultrasound examinations comprising conventional US, CEUS, and UE.Fine-needle aspiration biopsy (FNAB) or surgical specimens were the gold standard for definitive diagnosis.Patients with inconclusive diagnoses or incomplete examinations were excluded.Results: Conventional US (ACR TI-RADS) achieved an AUC of 0.802, excelling in detecting suspicious features but suffering from inherent subjectivity.CEUS, with an AUC of 0.854 and a remarkable sensitivity of 95.29%, captured specific malignant patterns like centripetal enhancement and uneven distribution, but its reliance on contrast limited its applicability.UE provided an area under the curve (AUC) of 0.845 and valuable information about tissue stiffness, but its efficacy was influenced by nodule size and location.However, the true strength emerged when combining all three modalities.Multimodal ultrasound yielded an impressive AUC of 0.958 and a sensitivity of 91.76%, significantly surpassing individual performances.Conclusion: Our findings demonstrate that multimodal ultrasound, integrating conventional US, CEUS, and UE, significantly outperforms individual modalities in diagnosing thyroid nodules.Further research is warranted to refine and optimize this promising diagnostic strategy to benefit patients with thyroid nodules.