Diagnostic performance of ultrasonography in predicting extrathyroidal extension in papillary thyroid carcinoma

Sonographic features like strap muscle replacement and obtuse tumor-trachea angles are highly specific for ETE and should strongly guide surgical planning. The assessment of RLN invasion, while sensitive, requires caution due to a high false-positive rate. Molecular profiling, particularly for BRAF + TERT co-mutations, significantly enhances risk stratification, underscoring the value of a tailored, multi-parameter preoperative evaluation.