Contrast-enhanced ultrasound time-intensity curve-assisted parametric imaging: a possible effective tool for...

It is difficult to use ultrasound to differentiate between benign and cancerous thyroid nodules. Contrast-enhanced ultrasound (CEUS)-related parametric imaging can efficiently show the vascular structural patterns of nodules, offering useful diagnostic data. The aim of this research is to evaluate the role of contrast parametric imaging in differentiating thyroid nodules.

A retrospective analysis of 146 thyroid nodules from 134 patients who underwent ultrasound and CEUS at Zhangzhou Affiliated Hospital of Fujian Medical University, Fujian Province, was carried out from October 2024 to March 2025. According to the American College of Radiology Thyroid Imaging Reporting and Data System (ACR-TIRADS) guidelines, junior and senior physicians performed double-blind interpretation to classify thyroid nodules, then junior and senior physicians reclassified using the CEUS-Thyroid Imaging Reporting and Data System (CEUS-TIRADS), and finally assisted with contrast parametric imaging for auxiliary diagnosis. Using pathological results as the "gold standard", the sensitivity, specificity, positive predictive value, negative predictive value, accuracy, Youden index, and area under the curve (AUC) of different seniority physicians using CEUS and time-intensity curve (TIC) to diagnose benign and malignant thyroid nodules were compared.

Out of 146 thyroid nodules assessed, 72 were malignant and 74 benign. Using the ACR-TIRADS system, senior physicians had a higher diagnostic accuracy (AUC of 0.834) than junior physicians (AUC of 0.730), with a significant difference (P<0.001). Incorporating CEUS improved AUCs for both groups (all P<0.01), but senior physicians still outperformed juniors (P<0.001). Contrast parametric imaging enhanced the diagnostic skills of both groups, particularly for juniors (0.114 compared to 0.047), leading to no notable difference in performance between the groups (P=0.07).

The diagnostic system utilizing parametric imaging with CEUS is highly valuable for distinguishing between benign and malignant thyroid nodules, and its combined use enhances diagnostic accuracy across varying physician experience levels.