{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,14]],"date-time":"2026-04-14T15:05:46Z","timestamp":1776179146754,"version":"3.50.1"},"reference-count":19,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2025,9,20]],"date-time":"2025-09-20T00:00:00Z","timestamp":1758326400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,9,20]],"date-time":"2025-09-20T00:00:00Z","timestamp":1758326400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["J Med Ultrasonics"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>Extranodal extension (ENE) of metastatic carcinoma in patients with papillary thyroid carcinoma (PTC) has been associated with an increased risk of recurrent disease, persistent disease, and disease-specific mortality; however, ultrasound findings suggestive of ENE have not been well established. In this study, we aimed to identify ultrasound findings suggestive of microscopic ENE and validate them histologically.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We retrospectively examined the ultrasound and histological findings of 21 PTC patients with microscopic ENE and 46 without ENE.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Node matting, irregular shapes, ill-defined jagged border, and perinodal hyperechoic rims were observed in 38.1%, 57.1%, 42.9%, and 57.1% of lymph nodes with ENE, respectively, and the frequencies were significantly higher than those without ENE, with\n                      <jats:italic>p<\/jats:italic>\n                      values less than 0.05, 0.0005, 0.0001, and 0.0001, respectively. The sensitivity and specificity of cases with any one of irregular shapes, ill-defined jagged border, and perinodal hyperechoic rims were 81.0% and 82.6%, respectively. Histologically, node matting, irregular shape, ill-defined jagged border, and a perinodal hyperechoic rim correspond to adhesion between lymph nodes, extensive invasion, minimal invasion, and invasion into adipose tissue, respectively.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>We would argue that any irregular shape, ill-defined jagged border, and perinodal hyperechoic rim can be accepted as findings indicative of microscopic ENE.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s10396-025-01573-w","type":"journal-article","created":{"date-parts":[[2025,9,20]],"date-time":"2025-09-20T02:19:05Z","timestamp":1758334745000},"page":"27-32","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Ultrasound findings suggestive of microscopic extranodal extension in papillary thyroid carcinoma"],"prefix":"10.1007","volume":"53","author":[{"ORCID":"https:\/\/orcid.org\/0009-0002-9218-4187","authenticated-orcid":false,"given":"Noriko","family":"Miyamoto","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5558-7142","authenticated-orcid":false,"given":"Mitsuyoshi","family":"Hirokawa","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8262-2652","authenticated-orcid":false,"given":"Miyoko","family":"Higuchi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-8597-2916","authenticated-orcid":false,"given":"Maki","family":"Oshita","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-7149-4516","authenticated-orcid":false,"given":"Makoto","family":"Kawakami","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-0044-2009","authenticated-orcid":false,"given":"Hiroyuki","family":"Yamaoka","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-4537-9423","authenticated-orcid":false,"given":"Makoto","family":"Fujishima","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0041-197X","authenticated-orcid":false,"given":"Akira","family":"Miyauchi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4960-8271","authenticated-orcid":false,"given":"Takashi","family":"Akamizu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2025,9,20]]},"reference":[{"key":"1573_CR1","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1089\/thy.2015.0020","volume":"26","author":"BR Haugen","year":"2016","unstructured":"Haugen BR, Alexander EK, Bible KC, et al. 2015 American Thyroid Association management guidelines for adult patients with thyroid nodules and differentiated thyroid cancer: the American Thyroid Association guidelines task force on thyroid nodules and differentiated thyroid cancer. 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