{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T10:45:41Z","timestamp":1790937941533,"version":"4.1.0"},"reference-count":41,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,1,28]],"date-time":"2026-01-28T00:00:00Z","timestamp":1769558400000},"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>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To assess the diagnostic performance of the Node Reporting and Data System (Node-RADS) in ultrasonographic evaluation of cervical lymph node (LN) metastasis in papillary thyroid carcinoma (PTC) and compare it with conventional suspicious sonographic features.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and methods<\/jats:title>\n                    <jats:p>This retrospective study included 227 PTC patients (269 LNs) who underwent preoperative cervical LN ultrasound and biopsy (September 2022\u2013December 2023). Two radiologists independently assigned Node-RADS scores (1\u20135) based on LN size and morphologic features (shape, border, echogenicity). Diagnostic performance was evaluated using ROC analysis, with\u00a0histopathology as the reference standard. Node-RADS was compared to\u00a0five\u00a0American Thyroid Association (ATA)-defined suspicious features (microcalcifications, cystic changes, etc.). Multivariable analysis assessed an integrated model combining Node-RADS with peripheral vascularity.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Metastatic LNs (63.9%, 172\/269) exhibited higher Node-RADS scores (malignancy rates: 35.7% for score 1 vs. 88.2% for score 5). Node-RADS achieved an AUC of 0.720 (95% CI: 0.662\u20130.773), surpassing individual features (best AUC: 0.703 for peripheral vascularity). Inter-reader agreement was good (\n                      <jats:italic>\u03ba<\/jats:italic>\n                      = 0.67). A combined Node-RADS and peripheral vascularity model significantly improved diagnostic performance (AUC: 0.825,\n                      <jats:italic>p<\/jats:italic>\n                      &amp;lt; 0.01).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Node-RADS offers standardized, reproducible risk stratification for cervical LN metastasis in PTC, with moderate diagnostic accuracy. Integration with peripheral vascularity enhances performance, supporting its potential clinical utility in preoperative assessment.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fendo.2026.1709522","type":"journal-article","created":{"date-parts":[[2026,1,28]],"date-time":"2026-01-28T05:23:02Z","timestamp":1769577782000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":2,"title":["Standardizing cervical lymph node evaluation in papillary thyroid carcinoma: diagnostic accuracy of Node-RADS on ultrasound"],"prefix":"10.3389","volume":"17","author":[{"given":"Hongjun","family":"Zhang","sequence":"first","affiliation":[{"name":"Seventh Affiliated Hospital, Sun Yat-sen University","place":["Shenzhen, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Danni","family":"He","sequence":"additional","affiliation":[{"name":"Seventh Affiliated Hospital, Sun Yat-sen University","place":["Shenzhen, 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