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This study aimed to validate the diagnostic accuracy of CDU for screening radiation\u2010induced common carotid artery (CCA) stenosis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We enrolled 134 HNC patients with 268 carotid arteries, all of whom underwent CDU and computed tomographic angiography. Diameter stenosis and hemodynamic parameters were assessed on CDU, with \u226550% stenosis on computed tomographic angiography serving as the reference standard. Diagnostic performance was evaluated using sensitivity, specificity, PPV, NPV, and receiver operating characteristic (ROC) analysis to identify optimal cutoff values.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Using a B\u2010mode cutoff of 50% to detect \u226550% CCA stenosis, the sensitivity, specificity, PPV, and NPV were 85.2, 88.1, 45.1, and 98.1%, respectively. The optimal B\u2010mode threshold of 53%, which yielded a sensitivity of 75.9%, specificity of 91.4%, PPV of 51.2%, and NPV of 96.9%, with an area under the ROC curve (AUROC) of 0.894. In comparison, the optimal PSV threshold of 203\u2009cm\/s showed lower sensitivity (51.7%) but higher specificity (99.2%), with a PPV of 88.2%, NPV of 94.6%, and an AUROC of 0.698. Combining B\u2010mode and PSV criteria resulted in an AUROC of 0.891, offering minimal incremental diagnostic benefit compared with B\u2010mode assessment alone.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>B\u2010mode CDU may be a feasible screening tool for radiation\u2010induced CCA stenosis. A B\u2010mode threshold of 53% achieved diagnostic performance comparable to combined B\u2010mode and velocity criteria for detecting \u226550% stenosis.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/jum.70232","type":"journal-article","created":{"date-parts":[[2026,3,8]],"date-time":"2026-03-08T17:08:01Z","timestamp":1772989681000},"page":"1843-1851","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Diagnostic Performance of Duplex Ultrasonography in Post\u2010Radiation Common Carotid Artery Stenosis"],"prefix":"10.1002","volume":"45","author":[{"given":"Min\u2010Shuo","family":"Chen","sequence":"first","affiliation":[{"name":"Department of Neurology, Chang Gung Memorial Hospital Linkou Medical Center  Taoyuan Taiwan"},{"name":"School of Medicine, College of Medicine Chang Gung University  Taoyuan 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