<scp>UE</scp> , <scp>CT</scp> , and <scp>ACR TI</scp> ‐ <scp>RADS</scp> Grading in the Combined Diagnosis of Benign and Malignant Thyroid Nodules

Accurate differentiation of benign and malignant thyroid nodules is crucial for clinical decisions, and multimodal imaging may outperform single modalities. We evaluated the clinical value of combining ultrasound elastography (UE), computed tomography (CT), and the American College of Radiology Thyroid Imaging Reporting and Data System (ACR TI-RADS) for distinguishing benign from malignant thyroid nodules. A single-center retrospective analysis of 80 consecutive patients with 100 thyroid nodules was conducted. All patients received ACR TI-RADS, UE, and CT, with surgical pathology as the gold standard. Sensitivity, specificity, accuracy, and pathological agreement were compared among individual tests and their combination. Pathology confirmed 31 malignant and 69 benign nodules. TI-RADS, UE, and CT showed moderate agreement with pathology (Kappa = 0.505, 0.530, 0.572), while the combined approach showed improved agreement (Kappa = 0.838) with fewer misdiagnoses and missed diagnoses. Cochran's Q test showed no significant difference in diagnostic accuracy among TI-RADS grading, UE, CT, and their combined use for benign and malignant thyroid nodules (p > 0.001). Combined use of UE, CT, and TI-RADS grading for diagnosing benign and malignant thyroid nodules improves consistency with pathological results, reduces misdiagnosis and missed diagnosis rates, and offers higher diagnostic value than single examinations.