{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T05:09:10Z","timestamp":1788930550557,"version":"build-2803163510"},"reference-count":51,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T00:00:00Z","timestamp":1788912000000},"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>Background<\/jats:title>\n                    <jats:p>This network meta-analysis (NMA) intends to fully assess the value of contrast-enhanced ultrasound (CEUS) combined with other imaging techniques in the diagnosis of thyroid nodules (TNs), and provide clinical guidance.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We systematically searched PubMed, Web of Science, Embase, and Cochrane up to October 15, 2025, and assessed study quality by the QUADAS-2 tool. The combination of CEUS and CEUS with other techniques was assessed for accuracy by R4.5.1 and ANOVA-based NMA.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Twenty-six original studies were included, encompassing 5022 TNs from 4484 patients. CEUS-ultrasound elastography (UE) demonstrated favorable diagnostic performance in differentiating benign and malignant TNs (superiority index [SI]: 3.47, 95%CI 0.2\u20137). The pooled sensitivity (SE) and specificity (SP) of CEUS-UE were 0.92 (95%CI 0.88\u20130.95, SUCRA 80.0%) and 0.83 (95%CI 0.75\u20130.89, SUCRA 60.7%), respectively. CEUS-artificial intelligence (AI) was generally effective in identifying high-risk TNs (SI: 3.81, 95%CI 0.33\u20139), with pooled SE and SP of 0.95 (95%CI 0.91\u20130.98, SUCRA 90.0%) and 0.81 (95%CI 0.68\u20130.91, SUCRA 49.6%), respectively. CEUS-conventional ultrasound (US) showed favorable diagnostic performance in identifying non-risk-stratified TNs (SI: 5.29, 95%CI 0.33\u20139), with pooled SE and SP of 0.89 (95% CI 0.74\u20130.97, SUCRA 61.4%) and 0.88 (95%CI 0.69\u20130.97, SUCRA 76.9%), respectively.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>CEUS-UE demonstrates favorable overall diagnostic performance in differentiating benign and malignant TNs. CEUS-AI may offer additional value in identifying high-risk TNs with multiple suspicious features. CEUS-US is effective in identifying non-risk-stratified TNs. However, these subgroup findings require further validation in larger, diverse external cohorts.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Systematic Review Registration<\/jats:title>\n                    <jats:p>\n                      <jats:ext-link>https:\/\/www.crd.york.ac.uk\/PROSPERO\/myprospero<\/jats:ext-link>\n                      , identifier CRD420251169562.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fendo.2026.1887134","type":"journal-article","created":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T04:40:19Z","timestamp":1788928819000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Diagnostic value of contrast-enhanced ultrasound combined with other imaging techniques in differentiating benign and malignant thyroid nodules: a network 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University of Chinese Medicine","place":["Harbin, Heilongjiang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ruirui","family":"Hou","sequence":"additional","affiliation":[{"name":"Endocrine Department I, The First Affiliated Hospital of Heilongjiang University of Chinese Medicine","place":["Harbin, Heilongjiang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhiyue","family":"Di","sequence":"additional","affiliation":[{"name":"Endocrine Department I, The First Affiliated Hospital of Heilongjiang University of Chinese Medicine","place":["Harbin, Heilongjiang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jian","family":"Ma","sequence":"additional","affiliation":[{"name":"Endocrine Department I, The First Affiliated Hospital of Heilongjiang University of Chinese Medicine","place":["Harbin, Heilongjiang, 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