Optimizing Frozen Section Sampling for Thyroid Follicular Neoplasms through Intraoperative Ultrasound Guidance

Objective: To investigate the clinical value of intraoperative high-frequency ultrasound in assessing the capsular continuity of thyroid follicular neoplasms and to evaluate its feasibility in guiding optimal frozen section sampling during surgical resection to improve diagnostic accuracy. Methods: Patients who were scheduled for surgical resection for thyroid follicular neoplasms were prospectively enrolled and randomized into a control group or an experimental group. In the experimental group, the excised specimens underwent comprehensive intraoperative high-frequency ultrasonography to identify areas suspected of capsular invasion, thereby guiding precise sampling for intraoperative frozen section analysis. The value of this method was assessed using permanent histopathology as the gold standard. Results: A total of 248 patients were included (130 in the control group and 118 in the experimental group). The diagnostic accuracy of intraoperative frozen section pathology was significantly greater in the experimental group than in the control group (91.53% vs. 77.69%, P < 0.05). Conclusion: Intraoperative high-frequency ultrasonography can effectively identify abnormalities in tumor capsular continuity, guide optimized sampling for intraoperative frozen section analysis, significantly improve the intraoperative detection of malignant tumors, and provide reliable intraoperative guidance (Figure 1).