{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T04:32:20Z","timestamp":1790051540171,"version":"4.0.1"},"reference-count":30,"publisher":"Springer Science and Business Media LLC","issue":"4","license":[{"start":{"date-parts":[[2025,9,21]],"date-time":"2025-09-21T00:00:00Z","timestamp":1758412800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.springernature.com\/gp\/researchers\/text-and-data-mining"},{"start":{"date-parts":[[2025,9,21]],"date-time":"2025-09-21T00:00:00Z","timestamp":1758412800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/www.springernature.com\/gp\/researchers\/text-and-data-mining"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["J Ultrasound"],"DOI":"10.1007\/s40477-025-01080-1","type":"journal-article","created":{"date-parts":[[2025,9,21]],"date-time":"2025-09-21T10:40:02Z","timestamp":1758451202000},"page":"1007-1016","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Evaluating the clinical impact of integrating superb microvascular imaging and shear wave elastography into TI-RADS"],"prefix":"10.1007","volume":"28","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6800-126X","authenticated-orcid":false,"given":"Melis","family":"Kosar Tunc","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6201-8204","authenticated-orcid":false,"given":"Rahmi Eren","family":"Ozkan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7896-2977","authenticated-orcid":false,"given":"Atalay","family":"Aktuna","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3388-9312","authenticated-orcid":false,"given":"Senay Erdogan","family":"Durmus","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5207-3314","authenticated-orcid":false,"given":"Hakan","family":"Onder","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,9,21]]},"reference":[{"issue":"3","key":"1080_CR1","doi-asserted-by":"publisher","first-page":"372","DOI":"10.1002\/cncr.30360","volume":"123","author":"BR Haugen","year":"2017","unstructured":"Haugen BR (2017) 2015 American Thyroid Association management guidelines for adult patients with thyroid nodules and differentiated thyroid cancer: what is new and what has changed? Cancer 123(3):372\u2013381. https:\/\/doi.org\/10.1002\/cncr.30360","journal-title":"Cancer"},{"key":"1080_CR2","doi-asserted-by":"publisher","DOI":"10.4158\/EP.16.3.468","author":"H Gharib","year":"2010","unstructured":"Gharib H et al (2010) American Association of Clinical Endocrinologists, Associazione Medici Endocrinologi, and European Thyroid Association medical guidelines for clinical practice for the diagnosis and management of thyroid nodules: executive summary of recommendations. Endocr Pract. https:\/\/doi.org\/10.4158\/EP.16.3.468","journal-title":"Endocr Pract"},{"key":"1080_CR3","doi-asserted-by":"publisher","DOI":"10.1530\/ETJ-22-0027","author":"M Grussendorf","year":"2022","unstructured":"Grussendorf M, Ruschenburg I, Brabant G (2022) Malignancy rates in thyroid nodules: a long-term cohort study of 17,592 patients. Eur Thyroid J. https:\/\/doi.org\/10.1530\/ETJ-22-0027","journal-title":"Eur Thyroid J"},{"key":"1080_CR4","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacr.2015.07.011","author":"EG Grant","year":"2015","unstructured":"Grant EG et al (2015) Thyroid ultrasound reporting lexicon: white paper of the ACR thyroid imaging, reporting and data system (TIRADS) committee. J Am Coll Radiol. https:\/\/doi.org\/10.1016\/j.jacr.2015.07.011","journal-title":"J Am Coll Radiol"},{"issue":"9","key":"1080_CR5","doi-asserted-by":"publisher","first-page":"1745","DOI":"10.1007\/s00018-019-03351-7","volume":"77","author":"R Lugano","year":"2020","unstructured":"Lugano R, Ramachandran M, Dimberg A (2020) Tumor angiogenesis: causes, consequences, challenges and opportunities. Cell Mol Life Sci 77(9):1745\u20131770. https:\/\/doi.org\/10.1007\/s00018-019-03351-7","journal-title":"Cell Mol Life Sci"},{"key":"1080_CR6","doi-asserted-by":"publisher","DOI":"10.1016\/j.ultrasmedbio.2013.03.009","author":"MH Wu","year":"2013","unstructured":"Wu MH et al (2013) Quantitative analysis of dynamic power doppler sonograms for patients with thyroid nodules. Ultrasound Med Biol. https:\/\/doi.org\/10.1016\/j.ultrasmedbio.2013.03.009","journal-title":"Ultrasound Med Biol"},{"key":"1080_CR7","doi-asserted-by":"publisher","DOI":"10.3389\/fendo.2023.1182259","author":"L Jiang","year":"2023","unstructured":"Jiang L, Zhang D, Chen Y-N, Yu X-J, Pan M-F, Lian L (2023) The value of conventional ultrasound combined with superb microvascular imaging and color Doppler flow imaging in the diagnosis of thyroid malignant nodules: a systematic review and meta-analysis. Front Endocrinol (Lausanne). https:\/\/doi.org\/10.3389\/fendo.2023.1182259","journal-title":"Front Endocrinol (Lausanne)"},{"issue":"5","key":"1080_CR8","doi-asserted-by":"publisher","first-page":"915","DOI":"10.1016\/j.ejrad.2015.12.011","volume":"85","author":"J Zhan","year":"2016","unstructured":"Zhan J, Diao X-H, Jin J-M, Chen L, Chen Y (2016) Superb microvascular imaging\u2014a new vascular detecting ultrasonographic technique for avascular breast masses: a preliminary study. Eur J Radiol 85(5):915\u2013921. https:\/\/doi.org\/10.1016\/j.ejrad.2015.12.011","journal-title":"Eur J Radiol"},{"key":"1080_CR9","doi-asserted-by":"publisher","DOI":"10.1016\/j.ultrasmedbio.2019.05.001","author":"L Chen","year":"2019","unstructured":"Chen L et al (2019) Additional value of superb microvascular imaging for thyroid nodule classification with the thyroid imaging reporting and data system. Ultrasound Med Biol. https:\/\/doi.org\/10.1016\/j.ultrasmedbio.2019.05.001","journal-title":"Ultrasound Med Biol"},{"issue":"3","key":"1080_CR10","doi-asserted-by":"publisher","first-page":"613","DOI":"10.1007\/s40477-024-00898-5","volume":"27","author":"D Negroni","year":"2024","unstructured":"Negroni D et al (2024) Superb microvascular imaging (SMI) and elastosonography in thyroid nodule: diagnostic value in a real-time cohort. J Ultrasound 27(3):613\u2013620. https:\/\/doi.org\/10.1007\/s40477-024-00898-5","journal-title":"J Ultrasound"},{"issue":"7","key":"1080_CR11","doi-asserted-by":"publisher","first-page":"1188","DOI":"10.21037\/gs-24-87","volume":"13","author":"Q Chen","year":"2024","unstructured":"Chen Q, Hu M, Bao F, Zhao H (2024) Combing superb microvascular imaging with shear wave elastography for risk stratification of Thyroid Imaging Reporting and Data System (TI-RADS) 4 thyroid nodules. Gland Surg 13(7):1188\u20131200. https:\/\/doi.org\/10.21037\/gs-24-87","journal-title":"Gland Surg"},{"key":"1080_CR12","doi-asserted-by":"publisher","DOI":"10.1007\/s10147-019-01397-y","author":"S Pei","year":"2019","unstructured":"Pei S et al (2019) Diagnostic value of multimodal ultrasound imaging in differentiating benign and malignant TI-RADS category 4 nodules. Int J Clin Oncol. https:\/\/doi.org\/10.1007\/s10147-019-01397-y","journal-title":"Int J Clin Oncol"},{"issue":"5","key":"1080_CR13","doi-asserted-by":"publisher","first-page":"e28725","DOI":"10.1097\/MD.0000000000028725","volume":"101","author":"MJ Hong","year":"2022","unstructured":"Hong MJ, Ahn HS, Ha SM, Park HJ, Oh J, Lalwani N (2022) Quantitative analysis of vascularity for thyroid nodules on ultrasound using superb microvascular imaging: Can nodular vascularity differentiate between malignant and benign thyroid nodules? Medicine 101(5):e28725","journal-title":"Medicine"},{"issue":"1","key":"1080_CR14","doi-asserted-by":"publisher","first-page":"89","DOI":"10.7863\/ultra.16.03043","volume":"36","author":"GCH Yang","year":"2017","unstructured":"Yang GCH, Fried KO (2017) Most thyroid cancers detected by sonography lack intranodular vascularity on color doppler imaging: review of the literature and sonographic-pathologic correlations for 698 thyroid neoplasms. J Ultrasound Med 36(1):89\u201394. https:\/\/doi.org\/10.7863\/ultra.16.03043","journal-title":"J Ultrasound Med"},{"key":"1080_CR15","doi-asserted-by":"publisher","DOI":"10.12659\/MSM.911695","author":"YC Zhu","year":"2018","unstructured":"Zhu YC, Zhang Y, Deng SH, Jiang Q (2018) A prospective study to compare superb microvascular imaging with grayscale ultrasound and color doppler flow imaging of vascular distribution and morphology in thyroid nodules. Med Sci Monit. https:\/\/doi.org\/10.12659\/MSM.911695","journal-title":"Med Sci Monit"},{"issue":"4","key":"1080_CR16","doi-asserted-by":"publisher","first-page":"355","DOI":"10.3233\/CH-211235","volume":"78","author":"W Zhao","year":"2021","unstructured":"Zhao W, Lu R, Yin L, Guo R (2021) The value of superb microvascular imaging (SMI) scoring assignment method in differentiating benign and malignant thyroid nodules by conventional ultrasound. Clin Hemorheology Microcirc 78(4):355\u2013363. https:\/\/doi.org\/10.3233\/CH-211235","journal-title":"Clin Hemorheology Microcirc"},{"key":"1080_CR17","doi-asserted-by":"publisher","first-page":"1029936","DOI":"10.3389\/fonc.2023.1029936","volume":"13","author":"H Luo","year":"2023","unstructured":"Luo H, Yin L (2023) Diagnostic value of superb microvascular imaging and color doppler for thyroid nodules: a meta-analysis. Front Oncol 13:1029936. https:\/\/doi.org\/10.3389\/fonc.2023.1029936","journal-title":"Front Oncol"},{"issue":"1","key":"1080_CR18","doi-asserted-by":"publisher","first-page":"230","DOI":"10.1186\/s13244-024-01806-5","volume":"15","author":"G Ma","year":"2024","unstructured":"Ma G et al (2024) Application of microvascular ultrasound-assisted thyroid imaging report and data system in thyroid nodule risk stratification. Insights Imaging 15(1):230. https:\/\/doi.org\/10.1186\/s13244-024-01806-5","journal-title":"Insights Imaging"},{"key":"1080_CR19","doi-asserted-by":"publisher","DOI":"10.3904\/kjim.2016.326","author":"HJ Kim","year":"2019","unstructured":"Kim HJ et al (2019) Utility of shear wave elastography to detect papillary thyroid carcinoma in thyroid nodules: efficacy of the standard deviation elasticity. Korean J Intern Med. https:\/\/doi.org\/10.3904\/kjim.2016.326","journal-title":"Korean J Intern Med"},{"key":"1080_CR20","doi-asserted-by":"publisher","DOI":"10.1007\/s00330-012-2495-1","author":"KSS Bhatia","year":"2012","unstructured":"Bhatia KSS, Tong CSL, Cho CCM, Yuen EHY, Lee YYP, Ahuja AT (2012) Shear wave elastography of thyroid nodules in routine clinical practice: preliminary observations and utility for detecting malignancy. Eur Radiol. https:\/\/doi.org\/10.1007\/s00330-012-2495-1","journal-title":"Eur Radiol"},{"key":"1080_CR21","doi-asserted-by":"publisher","DOI":"10.1186\/s13244-021-01074-7","author":"M Hazem","year":"2021","unstructured":"Hazem M et al (2021) Accuracy of shear wave elastography in characterization of thyroid nodules in children and adolescents. Insights Imaging. https:\/\/doi.org\/10.1186\/s13244-021-01074-7","journal-title":"Insights Imaging"},{"key":"1080_CR22","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejrad.2014.11.019","author":"AY Park","year":"2015","unstructured":"Park AY, Son EJ, Han K, Youk JH, Kim JA, Park CS (2015) Shear wave elastography of thyroid nodules for the prediction of malignancy in a large scale study. Eur J Radiol. https:\/\/doi.org\/10.1016\/j.ejrad.2014.11.019","journal-title":"Eur J Radiol"},{"issue":"12","key":"1080_CR23","doi-asserted-by":"publisher","first-page":"5281","DOI":"10.1210\/jc.2010-0766","volume":"95","author":"F Sebag","year":"2010","unstructured":"Sebag F et al (2010) Shear wave elastography: a new ultrasound imaging mode for the differential diagnosis of benign and malignant thyroid nodules. J Clin Endocrinol Metab 95(12):5281\u20135288. https:\/\/doi.org\/10.1210\/jc.2010-0766","journal-title":"J Clin Endocrinol Metab"},{"key":"1080_CR24","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejrad.2012.09.002","author":"JB Veyrieres","year":"2012","unstructured":"Veyrieres JB et al (2012) A threshold value in Shear Wave elastography to rule out malignant thyroid nodules: a reality? Eur J Radiol. https:\/\/doi.org\/10.1016\/j.ejrad.2012.09.002","journal-title":"Eur J Radiol"},{"key":"1080_CR25","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0081532","author":"E Szczepanek-Parulska","year":"2013","unstructured":"Szczepanek-Parulska et al (2013) Comparison of diagnostic value of conventional ultrasonography and shear wave elastography in the prediction of thyroid lesions malignancy. PLoS One. https:\/\/doi.org\/10.1371\/journal.pone.0081532","journal-title":"PLoS One"},{"key":"1080_CR26","doi-asserted-by":"publisher","DOI":"10.21053\/ceo.2019.01235","author":"EK Yeon","year":"2020","unstructured":"Yeon EK et al (2020) Diagnostic performance of a combination of shear wave elastography and b-mode ultrasonography in differentiating benign from malignant thyroid nodules. Clin Exp Otorhinolaryngol. https:\/\/doi.org\/10.21053\/ceo.2019.01235","journal-title":"Clin Exp Otorhinolaryngol"},{"key":"1080_CR27","doi-asserted-by":"publisher","DOI":"10.1007\/s11547-021-01349-5","author":"I Celletti","year":"2021","unstructured":"Celletti I et al (2021) TIRADS, SRE and SWE in INDETERMINATE thyroid nodule characterization: which has better diagnostic performance?. Radiol Med. https:\/\/doi.org\/10.1007\/s11547-021-01349-5","journal-title":"Radiol Med"},{"issue":"12","key":"1080_CR28","doi-asserted-by":"publisher","first-page":"4434","DOI":"10.1210\/jc.2015-3100","volume":"100","author":"N Kwong","year":"2015","unstructured":"Kwong N et al (2015) The influence of patient age on thyroid nodule formation, multinodularity, and thyroid cancer risk. J Clin Endocrinol Metab 100(12):4434\u20134440. https:\/\/doi.org\/10.1210\/jc.2015-3100","journal-title":"J Clin Endocrinol Metab"},{"key":"1080_CR29","doi-asserted-by":"publisher","first-page":"100380","DOI":"10.1016\/j.jcte.2024.100380","volume":"39","author":"Y Zhang","year":"2024","unstructured":"Zhang Y, Ye BB, Wang HX, Liu BJ, Liu YY, Wei Q, Qin C, Zhang YF (2024) Can ACR TI-RADS predict the malignant risk of medullary thyroid cancer?. J Clin Transl Endocrinol 39:100380. https:\/\/doi.org\/10.1016\/j.jcte.2024.100380","journal-title":"J Clin Transl Endocrinol"},{"issue":"1","key":"1080_CR30","doi-asserted-by":"publisher","first-page":"90","DOI":"10.1007\/s12020-019-01843-x","volume":"64","author":"L Gao","year":"2019","unstructured":"Gao L, Xi X, Jiang Y, Yang X, Wang Y, Zhu S, Lai X, Zhang X, Zhao R, Zhang B (2019) Comparison among TIRADS (ACR TI-RADS and KWAK- TI-RADS) and 2015 ATA Guidelines in the diagnostic efficiency of thyroid nodules. Endocrine 64(1):90\u201396. https:\/\/doi.org\/10.1007\/s12020-019-01843-x","journal-title":"Endocrine"}],"container-title":["Journal of Ultrasound"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s40477-025-01080-1.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s40477-025-01080-1\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s40477-025-01080-1.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,3]],"date-time":"2025-12-03T13:35:34Z","timestamp":1764768934000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s40477-025-01080-1"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,9,21]]},"references-count":30,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2025,12]]}},"alternative-id":["1080"],"URL":"https:\/\/doi.org\/10.1007\/s40477-025-01080-1","relation":{},"ISSN":["1876-7931"],"issn-type":[{"value":"1876-7931","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,9,21]]},"assertion":[{"value":"2 July 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"26 August 2025","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"21 September 2025","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The authors declare no conflict of interest. The authors have no relevant financial or non-financial interests to disclose.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}},{"value":"This prospective study was approved by the Ethics Committee of Prof. Dr. Cemil Tascioglu State Hospital (Approval Number: 251, Date: 14\/07\/2023). Written informed consent was obtained from all individual participants included in the study. The study was conducted in accordance with the ethical standards of the institutional and\/or national research committee and with the 1964 Helsinki Declaration and its later amendments. The authors declare that they have no conflict of interest. No funding was received for this research. This study was approved by the local institutional review board (IRB No. 2023\/251) and conducted in accordance with the Declaration of Helsinki.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval"}},{"value":"Informed consent was obtained from all participants.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Informed consent"}},{"value":"All authors agreed on the content of the paper.","order":5,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}}]}}