{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,10]],"date-time":"2026-02-10T05:34:32Z","timestamp":1770701672016,"version":"3.49.0"},"reference-count":18,"publisher":"Oxford University Press (OUP)","issue":"1177","license":[{"start":{"date-parts":[[2025,9,17]],"date-time":"2025-09-17T00:00:00Z","timestamp":1758067200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"DOI":"10.13039\/501100004735","name":"Hunan Provincial Natural Science Foundation of China","doi-asserted-by":"crossref","award":["2022JJ30827"],"award-info":[{"award-number":["2022JJ30827"]}],"id":[{"id":"10.13039\/501100004735","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/501100004735","name":"Hunan Provincial Natural Science Foundation of China","doi-asserted-by":"crossref","award":["2023JJ60090"],"award-info":[{"award-number":["2023JJ60090"]}],"id":[{"id":"10.13039\/501100004735","id-type":"DOI","asserted-by":"crossref"}]},{"name":"Natural Science Foundation of Hunan Provincial Health Commission","award":["A202309026329"],"award-info":[{"award-number":["A202309026329"]}]},{"name":"Natural Science Foundation of Hunan Provincial Health Commission","award":["B202209024035"],"award-info":[{"award-number":["B202209024035"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,1,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>Precise preoperative localization of parathyroid gland lesion is essential for guiding surgery in primary hyperparathyroidism (PHPT). The aim of our study was to investigate the contrast-enhanced ultrasound (CEUS) characteristics of parathyroid gland adenoma (PGA) and to evaluate whether PGA can be differentiated from central cervical lymph nodes (CCLN).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Fifty-four consecutive patients with PHPT were retrospectively enrolled and underwent preoperative imaging with high-resolution ultrasound (US) and CEUS, and underwent subsequent parathyroidectomy. One hundred seventy-four lymph nodes of papillary thyroid carcinomas (PTC) patients were examined by high-resolution US and CEUS, and underwent unilateral, subtotal, or total thyroidectomy with central neck dissection were enrolled. By incorporating US and CEUS characteristics, a predictive model presented as a nomogram was developed, and their performance and utility were evaluated by plotting receiver operating characteristic (ROC) curves, calibration curves and decision curve analysis (DCA).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Three US characteristics and 2 CEUS characteristics were independent characteristics related to PGA for their differentiation from CCLN, and were obtained for machine learning model construction. The area under the receiver characteristic curve (AUC) of the US + CEUS model was 0.915, was higher than the other US model (0.874) and CEUS model (0.791).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>It is recommended that CEUS techniques be used to enhance the diagnostic utility of US in cases of suspected parathyroid lesions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Advances in knowledge<\/jats:title>\n                    <jats:p>This is the first study to use a combination of US + CEUS to build a nomogram to distinguish between PGA and CCLN, filling a gap in the existing literatures.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/bjr\/tqaf230","type":"journal-article","created":{"date-parts":[[2025,9,19]],"date-time":"2025-09-19T23:22:59Z","timestamp":1758324179000},"page":"114-121","source":"Crossref","is-referenced-by-count":0,"title":["A novel ultrasound-based nomogram using contrast-enhanced and conventional ultrasound features to improve preoperative diagnosis of parathyroid adenomas\n                    <i>versus<\/i>\n                    cervical lymph nodes"],"prefix":"10.1093","volume":"99","author":[{"given":"Yan","family":"Xu","sequence":"first","affiliation":[{"name":"Department of Ultrasonography, The Second Xiangya Hospital, Central South University , Changsha 410011,","place":["China"]},{"name":"Research Center of Ultrasonography, The Second Xiangya Hospital, Central South University , Changsha 410011,","place":["China"]},{"name":"Clinical Research Center for Ultrasound Diagnosis and Treatment in Hunan Province , Changsha 410011,","place":["China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zhongkun","family":"Zuo","sequence":"additional","affiliation":[{"name":"Department of General Surgery, The Second Xiangya Hospital, Central South University , Changsha 410011,","place":["China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Qinghai","family":"Peng","sequence":"additional","affiliation":[{"name":"Department of Ultrasonography, The Second Xiangya Hospital, Central South University , Changsha 410011,","place":["China"]},{"name":"Research Center of Ultrasonography, The Second Xiangya Hospital, Central South University , Changsha 410011,","place":["China"]},{"name":"Clinical Research Center for Ultrasound Diagnosis and Treatment in Hunan Province , Changsha 410011,","place":["China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rongsen","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Ultrasonography, The Second Xiangya Hospital, Central South University , Changsha 410011,","place":["China"]},{"name":"Research Center of Ultrasonography, The Second Xiangya Hospital, Central South University , Changsha 410011,","place":["China"]},{"name":"Clinical Research Center for Ultrasound Diagnosis and Treatment in Hunan Province , Changsha 410011,","place":["China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0769-5397","authenticated-orcid":false,"given":"Kui","family":"Tang","sequence":"additional","affiliation":[{"name":"Department of Ultrasonography, The Second Xiangya Hospital, Central South University , Changsha 410011,","place":["China"]},{"name":"Research Center of Ultrasonography, The Second Xiangya Hospital, Central South University , Changsha 410011,","place":["China"]},{"name":"Clinical Research Center for Ultrasound Diagnosis and Treatment in Hunan Province , Changsha 410011,","place":["China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2060-6934","authenticated-orcid":false,"given":"Chengcheng","family":"Niu","sequence":"additional","affiliation":[{"name":"Department of Ultrasonography, The Second Xiangya Hospital, Central South University , Changsha 410011,","place":["China"]},{"name":"Research Center of Ultrasonography, The Second Xiangya Hospital, Central South University , Changsha 410011,","place":["China"]},{"name":"Clinical Research Center for Ultrasound Diagnosis and Treatment in Hunan Province , Changsha 410011,","place":["China"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2025,9,17]]},"reference":[{"key":"2026020906365954000_tqaf230-B1","doi-asserted-by":"crossref","first-page":"115","DOI":"10.1038\/nrendo.2017.104","article-title":"Primary hyperparathyroidism","volume":"14","author":"Walker","year":"2018","journal-title":"Nat Rev Endocrinol"},{"key":"2026020906365954000_tqaf230-B2","doi-asserted-by":"crossref","first-page":"64","DOI":"10.1007\/s12022-022-09709-1","article-title":"Overview of the 2022 WHO classification of parathyroid tumors","volume":"33","author":"Erickson","year":"2022","journal-title":"Endocr Pathol"},{"key":"2026020906365954000_tqaf230-B3","doi-asserted-by":"crossref","first-page":"168","DOI":"10.1016\/S0140-6736(17)31430-7","article-title":"Hyperparathyroidism","volume":"391","author":"Bilezikian","year":"2018","journal-title":"Lancet"},{"key":"2026020906365954000_tqaf230-B4","doi-asserted-by":"crossref","first-page":"959","DOI":"10.1001\/jamasurg.2016.2310","article-title":"The American association of endocrine surgeons guidelines for definitive management of primary hyperparathyroidism","volume":"151","author":"Wilhelm","year":"2016","journal-title":"JAMA Surg"},{"key":"2026020906365954000_tqaf230-B5","doi-asserted-by":"crossref","first-page":"1050","DOI":"10.1007\/s00259-023-06488-7","article-title":"Head-to-head comparison of [(11)C]methionine PET, [(11)C]choline PET, and 4-dimensional CT as second-line scans for detection of parathyroid adenomas in primary hyperparathyroidism","volume":"51","author":"Noltes","year":"2024","journal-title":"Eur J Nucl Med Mol Imaging"},{"key":"2026020906365954000_tqaf230-B6","doi-asserted-by":"crossref","first-page":"2801","DOI":"10.1007\/s00259-021-05334-y","article-title":"The EANM practice guidelines for parathyroid imaging","volume":"48","author":"Petranovic Ovcaricek","year":"2021","journal-title":"Eur J Nucl Med Mol Imaging"},{"key":"2026020906365954000_tqaf230-B7","doi-asserted-by":"crossref","first-page":"155","DOI":"10.1007\/s00423-023-02893-6","article-title":"18F-fluorocholine PET\/MRI versus ultrasound and sestamibi for the localization of parathyroid adenomas","volume":"408","author":"Noltes","year":"2023","journal-title":"Langenbecks Arch Surg"},{"key":"2026020906365954000_tqaf230-B8","doi-asserted-by":"crossref","first-page":"837","DOI":"10.2214\/ajr.174.3.1740837","article-title":"Imaging-based nodal classification for evaluation of neck metastatic adenopathy","volume":"174","author":"Som","year":"2000","journal-title":"AJR Am J Roentgenol"},{"key":"2026020906365954000_tqaf230-B9","doi-asserted-by":"crossref","first-page":"536","DOI":"10.1001\/archotol.134.5.536","article-title":"Consensus statement on the classification and terminology of neck dissection","volume":"134","author":"Robbins","year":"2008","journal-title":"Arch Otolaryngol Head Neck Surg"},{"key":"2026020906365954000_tqaf230-B10","doi-asserted-by":"crossref","first-page":"941905","DOI":"10.3389\/fendo.2022.941905","article-title":"Contrast-enhanced ultrasound characteristics of preoperative Central cervical lymph node metastasis in papillary thyroid carcinoma","volume":"13","author":"Ye","year":"2022","journal-title":"Front Endocrinol (Lausanne)"},{"key":"2026020906365954000_tqaf230-B11","doi-asserted-by":"crossref","first-page":"580","DOI":"10.1016\/j.surg.2011.08.010","article-title":"Contrast-enhanced ultrasonography for localization of pathologic glands in patients with primary hyperparathyroidism","volume":"151","author":"Agha","year":"2012","journal-title":"Surgery"},{"key":"2026020906365954000_tqaf230-B12","doi-asserted-by":"crossref","first-page":"2565","DOI":"10.1002\/jum.14949","article-title":"Potential utility of contrast-enhanced ultrasound in the preoperative evaluation of primary hyperparathyroidism","volume":"38","author":"Parra Ram\u00edrez","year":"2019","journal-title":"J Ultrasound Med"},{"key":"2026020906365954000_tqaf230-B13","doi-asserted-by":"crossref","first-page":"91","DOI":"10.1002\/jum.15984","article-title":"The diagnostic value of contrast enhanced ultrasound for localization of parathyroid lesions in primary hyperparathyroidism: comparison with color doppler ultrasound","volume":"42","author":"Piccin","year":"2023","journal-title":"J Ultrasound Med"},{"key":"2026020906365954000_tqaf230-B14","doi-asserted-by":"crossref","first-page":"587","DOI":"10.1016\/j.jacr.2017.01.046","article-title":"ACR thyroid imaging, reporting and data system (TI-RADS): white paper of the ACR TI-RADS committee","volume":"14","author":"Tessler","year":"2017","journal-title":"J Am Coll Radiol"},{"key":"2026020906365954000_tqaf230-B15","doi-asserted-by":"crossref","first-page":"370","DOI":"10.3348\/kjr.2016.17.3.370","article-title":"Ultrasonography diagnosis and imaging-based management of thyroid nodules: revised Korean society of thyroid radiology consensus statement and recommendations","volume":"17","author":"Shin","year":"2016","journal-title":"Korean J Radiol"},{"key":"2026020906365954000_tqaf230-B16","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1089\/thy.2015.0020","article-title":"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","volume":"26","author":"Haugen","year":"2016","journal-title":"Thyroid"},{"key":"2026020906365954000_tqaf230-B17","doi-asserted-by":"crossref","first-page":"147","DOI":"10.1159\/000354537","article-title":"2013 European thyroid association guidelines for cervical ultrasound scan and ultrasound-guided techniques in the postoperative management of patients with thyroid cancer","volume":"2","author":"Leenhardt","year":"2013","journal-title":"Eur Thyroid J"},{"key":"2026020906365954000_tqaf230-B18","doi-asserted-by":"crossref","first-page":"100751","DOI":"10.1016\/j.lanepe.2023.100751","article-title":"Differentiating pathologic parathyroid glands from thyroid nodules on neck ultrasound: the PARATH-US cross-sectional study","volume":"35","author":"Yazgi","year":"2023","journal-title":"Lancet Reg Health Eur"}],"container-title":["British Journal of Radiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/bjr\/advance-article-pdf\/doi\/10.1093\/bjr\/tqaf230\/64302459\/tqaf230.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/bjr\/article-pdf\/99\/1177\/114\/64302459\/tqaf230.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/bjr\/article-pdf\/99\/1177\/114\/64302459\/tqaf230.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,2,9]],"date-time":"2026-02-09T11:37:04Z","timestamp":1770637024000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/bjr\/article\/99\/1177\/114\/8256714"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,9,17]]},"references-count":18,"journal-issue":{"issue":"1177","published-online":{"date-parts":[[2025,9,17]]},"published-print":{"date-parts":[[2026,1,1]]}},"URL":"https:\/\/doi.org\/10.1093\/bjr\/tqaf230","relation":{},"ISSN":["0007-1285","1748-880X"],"issn-type":[{"value":"0007-1285","type":"print"},{"value":"1748-880X","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2026,1]]},"published":{"date-parts":[[2025,9,17]]}}}