Six ultrasound characteristics showed significant associations with thyroid malignancies in patients with medullary thyroid carcinoma (MTC), as published in Frontiers in Molecular Biosciences.

The authors investigated ultrasound characteristics and their predictive abilities of malignancy in multiple types of thyroid carcinomas including MTC, papillary thyroid carcinoma (PTC), and follicular thyroid carcinoma (FTC).

During univariate analysis, the study found that irregular or microlobulated margins (IRE), invasion of the thyroid capsule (ITC), blood flow by color Doppler flow imaging (CDFI), round, halo sign (AUR), and up-location (UPL) indicators were all significantly (P <.05) associated with tumor malignancies in patients with MTC.

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Of these characteristics, ITC showed the highest odds ratio of 8.10 (95% CI, 3.75-9.14).

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Further analysis using logistic modeling revealed that IRE, ITC, CDFI, and UPL were useful for building predictive models for the MTC malignancy. Using the predictive model resulted in an area under the receiver-operating characteristic curve of 0.801.

“This study aimed to determine the diagnostic accuracy and establish models using all ultrasound features including the nodule size for predicting the malignancy of thyroid nodules (PTC, FTC, and MTC) in China,” the authors said.

“We applied logistic regression to the data of 1,500 patients who received medical treatment in Shanghai and Fujian.”

In patients with PTC, hypoechogenicity (ECHO), IRE, taller-than-wide ratio > 1, echogenic focus, ITC, and round were found to be significant characteristics of malignancy, while only ECHO, CDFI, microcalcification, and AUR were significant in patients with FTC.

During the study period (January 2015 to August 2019), 1505 patients underwent thyroidectomies at the Ruijin Hospital in Shanghai or the Fujian Union Hospital in Fuzhou, China. Of these patients, 1000 were confirmed with PTC, 80 had FTC, 40 had MTC, and 385 had benign tumors.


Jiang S, Xie Q, Li N, Chen H, Chen X. Modified models for predicting malignancy using ultrasound characters have high accuracy in thyroid nodules with small size. Front Mol Biosci. 2021;8(26). doi:10.3389/fmolb.2021.752417