{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,4]],"date-time":"2025-11-04T06:38:24Z","timestamp":1762238304549,"version":"build-2065373602"},"reference-count":33,"publisher":"Korean Society of Ultrasound in Medicine","issue":"6","license":[{"start":{"date-parts":[[2025,9,11]],"date-time":"2025-09-11T00:00:00Z","timestamp":1757548800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/3.0\/"}],"content-domain":{"domain":["e-ultrasonography.org"],"crossmark-restriction":true},"short-container-title":["Ultrasonography"],"published-print":{"date-parts":[[2025,11,1]]},"abstract":"<jats:p>Purpose: This study aimed to analyze the ultrasonographic characteristics of differentiated thyroid cancer (DTC) with multigenic co-mutations and to establish a predictive model using contrast-enhanced ultrasonography (CEUS).Methods: This retrospective study included consecutive patients with pathologically confirmed DTC who underwent preoperative CEUS and next-generation sequencing at the authors\u2019 institution between September 2021 and December 2023. Clinical and CEUS features were compared between patients with and without multigenic co-mutations. Bayesian logistic regression (non-informative normal priors) was applied for predictor selection and model development, with Markov-chain Monte Carlo (MCMC) convergence checks and posterior predictive validation. Internal validation was performed using bootstrap resampling (n=1,000 iterations) to evaluate model stability.Results: A total of 116 patients (mean age, 39.84\u00b111.02 years; 33 men) were included, of whom 12 had multigenic co-mutations and 104 did not. Patients with multigenic co-mutations demonstrated a higher incidence of aggressive histological subtypes (25.0% vs. 1.9%, P=0.008) and lymph node metastasis (83.3% vs. 51.9%, P=0.038). Tumor size, enhancement homogeneity, and contrast agent arrival time were identified as significant predictors, with robust posterior distributions (all inclusion probabilities &amp;gt;0.9) and satisfactory MCMC convergence (potential scale reduction factor &amp;lt;1.01). The model achieved an area under the curve (AUC) of 0.873, with posterior predictive checks confirming favorable predicted-observed agreement (coverage \u22650.85). Internal validation with 1,000 bootstrap replicates yielded a consistent AUC of 0.880 (95% confidence interval, 0.745 to 0.978).Conclusion: The CEUS-based predictive model demonstrated strong discrimination for detecting multigenic co-mutations in differentiated thyroid cancer; however, external validation is required to confirm its clinical applicability.<\/jats:p>","DOI":"10.14366\/usg.25146","type":"journal-article","created":{"date-parts":[[2025,10,13]],"date-time":"2025-10-13T07:20:30Z","timestamp":1760340030000},"page":"511-520","update-policy":"https:\/\/doi.org\/10.14366\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Predicting multigenic co-mutations in differentiated thyroid cancer using contrast-enhanced ultrasonography: model development and internal validation"],"prefix":"10.14366","volume":"44","author":[{"ORCID":"https:\/\/orcid.org\/0009-0007-4446-2417","authenticated-orcid":true,"given":"Wenxin","family":"Xu","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-6798-4255","authenticated-orcid":true,"given":"Haishan","family":"Lin","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7630-5519","authenticated-orcid":true,"given":"Jingliang","family":"Ruan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-2917-2940","authenticated-orcid":true,"given":"Yuxuan","family":"Hu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-9649-1114","authenticated-orcid":true,"given":"Xi","family":"Huang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-2815-0077","authenticated-orcid":true,"given":"Haolin","family":"Qiu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2331-5713","authenticated-orcid":true,"given":"Baoming","family":"Luo","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"5473","reference":[{"key":"ref1","doi-asserted-by":"publisher","DOI":"10.3322\/caac.21660"},{"key":"ref2","first-page":"925","volume-title":"Thyroid 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