{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T22:41:46Z","timestamp":1788907306201,"version":"build-2803163510"},"reference-count":36,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,2,19]],"date-time":"2025-02-19T00:00:00Z","timestamp":1739923200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Endocrinol."],"abstract":"<jats:sec><jats:title>Introduction<\/jats:title><jats:p>Medullary thyroid carcinoma (MTC) is aggressive and difficult to distinguish from papillary thyroid carcinoma (PTC) using traditional ultrasound. Objective to establish a standard-based ultrasound imaging model for preoperative differentiation of MTC from PTC.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A retrospective study was conducted on the case data of 213 thyroid cancer patients (82 MTC, 90 lesions; 131 PTC, 135 lesions) from the Department of Diagnostic and Therapeutic Ultrasonography, Tianjin Medical University Cancer Institute and Hospital. We constructed clinical model, radiomics model and comprehensive model by executing machine learning algorithms based on baseline clinical, pathological characteristics and ultrasound image data, respectively.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The study showed that the comprehensive model observed the highest diagnostic efficacy in differentiating MTC from PTC with AUC, sensitivity, specificity, positive predictive value, negative predictive value and accuracy of 0.93, 0.88, 0.82, 0.77, 0.91, 85.8%. Delong test results showed that the comprehensive model was significantly better than the clinical model (Z=-3.791, P&amp;lt;0.001) and the radiomics model (Z=-2.017, <jats:italic>P<\/jats:italic>=0.044). Calibration curves indicated the comprehensive model and the radiomics model exhibited better stability than the clinical model. Decision curves analysis (DCA) demonstrated that the comprehensive model had the highest clinical net benefit.<\/jats:p><\/jats:sec><jats:sec><jats:title>Discussions<\/jats:title><jats:p>Radiomics model is effective in identifying MTC and PTC preoperatively, and the comprehensive model is better. This approach can aid in identifying the pathologic types of thyroid nodule before clinical operation, supporting personalized medicine in the decision-making process.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fendo.2025.1428888","type":"journal-article","created":{"date-parts":[[2025,2,19]],"date-time":"2025-02-19T06:53:46Z","timestamp":1739948026000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":5,"title":["Ultrasonic radiomics in predicting pathologic type for thyroid cancer: a preliminary study using radiomics features for predicting medullary thyroid carcinoma"],"prefix":"10.3389","volume":"16","author":[{"given":"Dai","family":"Zhang","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fan","family":"Yang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wenjing","family":"Hou","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ying","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiali","family":"Mu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hailing","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xi","family":"Wei","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2025,2,19]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(23)00020-X","article-title":"Thyroid cancer","volume":"401","author":"Chen","year":"2023","journal-title":"Lancet."},{"key":"B2","doi-asserted-by":"publisher","DOI":"10.1089\/thy.2021.0033","article-title":"Thyrotropin suppression for papillary thyroid cancer: A physician survey study","volume":"31","author":"Papaleontiou","year":"2021","journal-title":"Thyroid."},{"key":"B3","doi-asserted-by":"publisher","DOI":"10.3390\/cancers14153643","article-title":"Update on the diagnosis and management of medullary thyroid cancer: what has changed in recent years","volume":"14","author":"Kaliszewski","year":"2022","journal-title":"Cancers (Basel)."},{"key":"B4","doi-asserted-by":"publisher","DOI":"10.1530\/EJE-22-0312","article-title":"MANAGEMENT OF ENDOCRINE DISEASE: Medullary thyroid cancer: from molecular biology and therapeutic pitfalls to future targeted treatment perspectives","volume":"187","author":"Saltiki","year":"2022","journal-title":"Eur J Endocrinol"},{"key":"B5","doi-asserted-by":"publisher","DOI":"10.1007\/s00330-020-07591-1","article-title":"Comparison of diagnostic performance of the ACR and Kwak TIRADS applying the ACR TIRADS\u2019 size thresholds for FNA","volume":"31","author":"Huh","year":"2021","journal-title":"Eur Radiol"},{"key":"B6","doi-asserted-by":"publisher","first-page":"10632","DOI":"10.1038\/s41598-020-67543-z","article-title":"Diagnostic performances and unnecessary US-FNA rates of various TIRADS after application of equal size thresholds","volume":"10","author":"Huh","year":"2020","journal-title":"Sci Rep"},{"key":"B7","doi-asserted-by":"publisher","first-page":"41","DOI":"10.1186\/s40644-022-00478-y","article-title":"Diagnostic performance of simplified TI-RADS for Malignant thyroid nodules: comparison with 2017 ACR-TI-RADS and 2020 C-TI-RADS","volume":"22","author":"Chen","year":"2022","journal-title":"Cancer Imaging."},{"key":"B8","doi-asserted-by":"publisher","DOI":"10.1002\/jum.15918","article-title":"Ultrasonic characterization of primary squamous cell carcinoma of the thyroid","volume":"41","author":"Zhang","year":"2022","journal-title":"J Ultrasound Med"},{"key":"B9","doi-asserted-by":"publisher","first-page":"47","DOI":"10.1590\/0100-3984.2020.0141","article-title":"The 2017 ACR TI-RADS: pictorial essay","volume":"55","author":"Pires","year":"2022","journal-title":"Radiol Bras"},{"key":"B10","doi-asserted-by":"publisher","DOI":"10.1007\/s12020-022-03271-w","article-title":"Predicting Malignancy in thyroid nodules based on conventional ultrasound and elastography: the value of predictive models in a multi-center study","volume":"80","author":"Zhang","year":"2023","journal-title":"Endocrine."},{"key":"B11","doi-asserted-by":"publisher","first-page":"145","DOI":"10.1186\/s12902-022-01053-z","article-title":"Clinical diagnostic value of American College of Radiology thyroid imaging report and data system in different kinds of thyroid nodules","volume":"22","author":"Zhang","year":"2022","journal-title":"BMC Endocr Disord"},{"key":"B12","doi-asserted-by":"publisher","DOI":"10.1002\/cam4.2217","article-title":"The application value of modified thyroid imaging report and data system in diagnosing medullary thyroid carcinoma","volume":"8","author":"Zhu","year":"2019","journal-title":"Cancer Med"},{"key":"B13","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejca.2011.11.036","article-title":"Radiomics: extracting more information from medical images using advanced feature analysis","volume":"48","author":"Lambin","year":"2012","journal-title":"Eur J Cancer."},{"key":"B14","doi-asserted-by":"publisher","DOI":"10.12659\/MSM.926096","article-title":"Ensemble deep learning model for multicenter classification of thyroid nodules on ultrasound images","volume":"26","author":"Wei","year":"2020","journal-title":"Med Sci Monit"},{"key":"B15","doi-asserted-by":"publisher","DOI":"10.1007\/s11548-018-1796-5","article-title":"Comparison of the application of B-mode and strain elastography ultrasound in the estimation of lymph node metastasis of papillary thyroid carcinoma based on a radiomics approach","volume":"13","author":"Liu","year":"2018","journal-title":"Int J Comput Assist Radiol Surg"},{"key":"B16","doi-asserted-by":"publisher","DOI":"10.21037\/gs.2019.08.06","article-title":"Vascular flow on doppler sonography may not be a valid characteristic to distinguish colloid nodules from papillary thyroid carcinoma even when accounting for nodular size","volume":"8","author":"Debnam","year":"2019","journal-title":"Gland Surg"},{"key":"B17","doi-asserted-by":"publisher","DOI":"10.1016\/0301-5629(90)90020-D","article-title":"Doppler ultrasound color flow imaging in the study of breast cancer: preliminary findings","volume":"16","author":"Adler","year":"1990","journal-title":"Ultrasound Med Biol"},{"key":"B18","doi-asserted-by":"publisher","DOI":"10.1016\/j.esmoop.2021.100183","article-title":"How I treat medullary thyroid cancer","volume":"6","author":"Kiesewetter","year":"2021","journal-title":"ESMO Open"},{"key":"B19","doi-asserted-by":"publisher","DOI":"10.1016\/j.beem.2022.101655","article-title":"Medullary thyroid cancer - An update","volume":"37","author":"Fugazzola","year":"2023","journal-title":"Best Pract Res Clin Endocrinol Metab"},{"key":"B20","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaccao.2022.04.004","article-title":"How to treat renal cell carcinoma: the current treatment landscape and cardiovascular toxicities","volume":"4","author":"Castro","year":"2022","journal-title":"JACC CardioOncol."},{"key":"B21","doi-asserted-by":"publisher","DOI":"10.3348\/kjr.2019.0581","article-title":"Computer-aided diagnosis system for the evaluation of thyroid nodules on ultrasonography: prospective non-inferiority study according to the experience level of radiologists","volume":"21","author":"Chung","year":"2020","journal-title":"Korean J Radiol"},{"key":"B22","doi-asserted-by":"publisher","DOI":"10.3803\/EnM.2024.104","article-title":"It is time to understand the additional benefits of active surveillance for low-risk papillary thyroid carcinoma","volume":"39","author":"Kim","year":"2024","journal-title":"Endocrinol Metab (Seoul)."},{"key":"B23","doi-asserted-by":"publisher","DOI":"10.1210\/endrev\/bnad013","article-title":"Medullary thyroid cancer- updates and challenges","volume":"44","author":"Gild","year":"2023","journal-title":"Endocr Rev"},{"key":"B24","doi-asserted-by":"publisher","DOI":"10.1016\/j.intimp.2024.113532","article-title":"Biomarkers associated with papillary thyroid carcinoma and Hashimoto\u2019s thyroiditis: Bioinformatic analysis and experimental validation","volume":"143","author":"Li","year":"2024","journal-title":"Int Immunopharmacol."},{"key":"B25","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2023.26348","article-title":"Thyroid cancer: A review","volume":"331","author":"Boucai","year":"2024","journal-title":"JAMA."},{"key":"B26","doi-asserted-by":"publisher","DOI":"10.1016\/j.ultrasmedbio.2020.12.023","article-title":"Correlation between ultrasonic features of medullary thyroid carcinoma and cervical lymph node metastasis","volume":"47","author":"Zhu","year":"2021","journal-title":"Ultrasound Med Biol"},{"key":"B27","doi-asserted-by":"publisher","first-page":"344","DOI":"10.1186\/s12885-021-07953-y","article-title":"Correlation between preoperative ultrasonic features of medullary thyroid carcinoma and postoperative recurrence","volume":"21","author":"Zhu","year":"2021","journal-title":"BMC Cancer."},{"key":"B28","doi-asserted-by":"publisher","DOI":"10.1245\/s10434-020-09567-3","article-title":"Construction and validation of a nomogram based on the log odds of positive lymph nodes to predict the prognosis of medullary thyroid carcinoma after surgery","volume":"28","author":"Tang","year":"2021","journal-title":"Ann Surg Oncol"},{"key":"B29","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1016\/j.pbiomolbio.2022.08.004","article-title":"A survey on gene expression data analysis using deep learning methods for cancer diagnosis","volume":"177","author":"Ravindran","year":"2023","journal-title":"Prog Biophys Mol Biol"},{"key":"B30","doi-asserted-by":"publisher","DOI":"10.1177\/11795549221097675","article-title":"Radiomics features of different sizes of medullary thyroid carcinoma (MTC) and papillary thyroid carcinoma (PTC) tumors: A comparative study","volume":"16","author":"Zhao","year":"2022","journal-title":"Clin Med Insights Oncol"},{"key":"B31","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejro.2023.100476","article-title":"Radiogenomics study to predict the nuclear grade of renal clear cell carcinoma","volume":"10","author":"He","year":"2023","journal-title":"Eur J Radiol Open"},{"key":"B32","doi-asserted-by":"publisher","DOI":"10.1007\/s00330-020-07112-0","article-title":"Radiomics derived from dynamic contrast-enhanced MRI pharmacokinetic protocol features: the value of precision diagnosis ovarian neoplasms","volume":"31","author":"Song","year":"2021","journal-title":"Eur Radiol"},{"key":"B33","doi-asserted-by":"publisher","DOI":"10.1002\/pros.24442","article-title":"Ultrasound-based radiomics score for pre-biopsy prediction of prostate cancer to reduce unnecessary biopsies","volume":"83","author":"Ou","year":"2023","journal-title":"Prostate."},{"key":"B34","doi-asserted-by":"publisher","first-page":"56","DOI":"10.1016\/j.lungcan.2023.01.001","article-title":"Radiogenomics in lung cancer: Where are we","volume":"176","author":"Aguado-Barrera","year":"2023","journal-title":"Lung Cancer"},{"key":"B35","doi-asserted-by":"publisher","DOI":"10.1002\/cam4.7155","article-title":"The machine learning-based model for lateral lymph node metastasis of thyroid medullary carcinoma improved the prediction ability of occult metastasis","volume":"13","author":"Zhang","year":"2024","journal-title":"Cancer Med"},{"key":"B36","doi-asserted-by":"publisher","DOI":"10.3389\/fendo.2023.1209978","article-title":"Early postoperative prediction of the risk of distant metastases in medullary thyroid cancer","volume":"14","author":"Zhang","year":"2023","journal-title":"Front Endocrinol (Lausanne)."}],"container-title":["Frontiers in Endocrinology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fendo.2025.1428888\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,2,19]],"date-time":"2025-02-19T06:53:48Z","timestamp":1739948028000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fendo.2025.1428888\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,2,19]]},"references-count":36,"alternative-id":["10.3389\/fendo.2025.1428888"],"URL":"https:\/\/doi.org\/10.3389\/fendo.2025.1428888","relation":{},"ISSN":["1664-2392"],"issn-type":[{"value":"1664-2392","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,2,19]]},"article-number":"1428888"}}