{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T15:52:13Z","timestamp":1753890733189,"version":"3.41.2"},"reference-count":30,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,3,3]],"date-time":"2025-03-03T00:00:00Z","timestamp":1740960000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100004735","name":"Natural Science Foundation of Hunan Province","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100004735","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Endocrinol."],"abstract":"<jats:sec><jats:title>Objectives<\/jats:title><jats:p>This study aimed to explore the performance of a model based on Chinese Thyroid Imaging Reporting and Data Systems (C-TIRADS), clinical characteristics, and other ultrasound characteristics for the prediction of Bethesda III\/IV thyroid nodules before fine needle aspiration (FNA).<\/jats:p><\/jats:sec><jats:sec><jats:title>Materials and methods<\/jats:title><jats:p>A total of 855 thyroid nodules from 810 patients were included. All nodules underwent ultrasound examination before FNA. All nodules were categorized according to the C-TIRADS criteria and classified into two groups, Bethesda III\/IV and non-III\/IV thyroid nodules, using cytologic diagnosis as the gold standard. The clinical and ultrasonographic characteristics of the nodules in the two groups were compared, and independent predictors of Bethesda III\/IV nodules were determined by univariate and multivariate logistic regression analyses, based on which a prediction model was constructed. The predictive efficacy of the model was compared with that of C-TIRADS alone by sensitivity, specificity, and area under the curve (AUC).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Our study found that the C-TIRADS category, homogeneous echotexture, blood flow signal present, and posterior echo unchanged were independent predictors for Bethesda III\/IV thyroid nodules. Based on multiple logistic regression, a predictive model was established: Logit (p)= - 4.213 + 0.965 \u00d7 homogeneous echotexture+ 1.050 \u00d7 blood flow signal present + 0.473 \u00d7 posterior echo unchanged+ 2.859 \u00d7 C-TIRADS 3 + 2.804 \u00d7 C-TIRADS 4A + 1.824 \u00d7 C-TIRADS 4B + 0.919 \u00d7 C-TIRADS 4C. The AUC of the model among all\u00a0nodules was 0.746 (95%CI: 0.710-0.782), 0.779 (95%CI: 0.730-0.829) among nodules with a diameter (D) &amp;gt; 10mm, and 0.718 (95%CI: 0.667-0.769) among nodules with D \u2264 10mm, which were significantly higher than that of the C-TIRADS alone.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>We developed a predictive model for Bethesda III\/IV thyroid nodules that is better for nodules with D &amp;gt; 10mm FNA operators can choose the optimal puncture strategy based on the prediction results to improve the rate of definitive diagnosis of the first FNA of Bethesda III\/IV nodules and thus reduce repeat FNA.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fendo.2025.1442575","type":"journal-article","created":{"date-parts":[[2025,3,3]],"date-time":"2025-03-03T05:16:27Z","timestamp":1740978987000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["A model based on 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