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This retrospective study examined diagnostic accuracy of shear-wave elastography (SWE)-guided US-FNA and determined ultrasound features linked to misclassification in adults undergoing US-FNA from January 2023 to December 2024. Conventional ultrasound and SWE localized the stiffest intranodular region, with surgical histopathology as the reference.",{"@graph":69,"@context":123},[70,84,106],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/ultrasound-parameters-affecting-the-diagnostic-accuracy-of-ultrasound-guided-fine-needle-aspiration-for-thyroid-nodules-observational-study/449604/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/ultrasound-parameters-affecting-the-diagnostic-accuracy-of-ultrasound-guided-fine-needle-aspiration-for-thyroid-nodules-observational-study/449604.png","ImageObject",300,407,{"name":92,"@type":93},"awa","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-10-30","2026-09-30",true,{"@type":102,"interactionType":103,"userInteractionCount":105},"InteractionCounter",{"@type":104},"ViewAction",12,{"@type":107,"mainEntity":108},"FAQPage",[109,115,119],{"name":110,"@type":111,"acceptedAnswer":112},"What clinical problem does the study address?","Question",{"text":113,"@type":114},"It addresses how ultrasonographic parameters may influence sampling adequacy and cytologic classification accuracy in ultrasound-guided fine-needle aspiration for thyroid nodules.","Answer",{"name":116,"@type":111,"acceptedAnswer":117},"How was diagnostic accuracy evaluated?",{"text":118,"@type":114},"SWE-guided US-FNA targeted the stiffest intranodular region, and surgical histopathology served as the reference standard. Accuracy agreement was quantified using Kappa and odds ratios from logistic regression.",{"name":120,"@type":111,"acceptedAnswer":121},"Which ultrasound factors were associated with reduced diagnostic accuracy?",{"text":122,"@type":114},"Multivariable analysis showed reduced diagnostic accuracy with nodule diameter \u003C10 mm, intranodular calcification, and cystic component >50%.","https://schema.org",{"og:url":83,"og:type":125,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":127,"canonical":83},"index,follow",{"doc_id":129,"site_id":62},449604,1790811288,{"code":4,"msg":5,"data":132},{"doc_id":129,"user_id":133,"nickname":92,"user_avatar":134,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":135,"file_id":136,"file_url":137,"file_type":138,"file_size":139,"view_count":105,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":29,"language":140,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":141,"faqs":142,"seo_title":143,"seo_description":67,"update_tm":144,"read_time":145,"preview_page_count":4},3985747858093,"https://ap-avatar.wpscdn.com/davatar_3d24733baf745e90a7e4bdd5f77d97b2","®  \n Observational Study   \nUltrasound parameters affecting the diagnostic accuracy of ultrasound-guided fine-needle aspiration for thyroid nodules  \nZhen He, BMa ,* , Guoqiang Wu, BMa  \n\n| Abstract\u003Cbr>Ultrasound-guided fine-needle aspiration (US-FNA) is central to the evaluation of thyroid nodules. However, specific ultrasonographic parameters may influence sampling adequacy and cytologic classification. This study assessed the diagnostic accuracy of shearwave elastography (SWE)-guided US-FNA and identified ultrasound features associated with misclassification. This retrospective study enrolled adults undergoing US-FNA between January 2023 and December 2024 according to American Thyroid Association indications. Conventional ultrasound and SWE were used to localize the stiffest intranodular region for targeted aspiration. Surgical histopathology served as the reference standard. Variables included demographics, Hashimoto’s thyroiditis, nodulesize, calcification, cystic proportion, carotid pulsation, and nodule-to-carotid distance. Agreement was quantified by Kappa (κ) . Factors associated with diagnostic accuracy were examined using univariate and multivariable logistic regression, reported as odds ratios (ORs) with 95% confidence intervals (CIs) . A total of 186 patients with 200 nodules were analyzed: 80 malignant (predominantly papillary thyroid carcinoma) and 120 benign. SWE-guided US-FNA yielded sensitivity 92.5%, specificity 88.3%, accuracy 90.0%, positive predictive value 84. 1%, negative predictive value 94.6%, and κ = 0.81 (P \u003C .001) . On multivariable analysis, nodule diameter \u003C 10 mm (OR: 2.84, 95% CI: 1.17–6.90), intranodular calcification (OR: 2. 12, 95% CI: 1.01–4.47), and cystic component > 50%(OR: 3.36, 95% CI: 1.18–9.56) independently reduced diagnostic accuracy. SWE-guided US-FNA demonstrates high concordance with histopathology. Small size, calcification, and cyst-predominant composition are independent risk contexts for misclassification and should inform pre-procedural planning, target selection, and adequacy safeguards. |\n| --- |\n| Abbreviations: CI = confidence interval , FNA = fine-needle aspiration, OR = odds ratio, SWE = shear-wave elastography, US = ultrasound, US-FNA = ultrasound-guided fine-needle aspiration. |\n| Keywords: diagnostic accuracy, logistic regression, papillary thyroid carcinoma, shear-wave elastography (SWE) , thyroid nodules, ultrasound-guided fine-needle aspiration |\n\n1. Introduction  \nThyroid nodules represent a prevalent clinical entity, with an estimated prevalence ranging from 19% to 68% in the general population when detected by high-resolution ultrasonography. Although the majority of nodules are benign, approximately 5% to 15% harbor malignancy, primarily differentiated thyroid carcinoma. [1,2] Early and accurate identification of malignant nodules is critical for guiding clinical management, minimizing unnecessary surgical interventions, and optimizing patient outcomes. Fine-needle aspiration (FNA), when performed under ultrasound guidance, remains the cornerstone of diagnostic evaluation for thyroid nodules due to its safety, cost-effectiveness, and high diagnostic yield. Despite its established role,  \nThe research was funded by Talent introduction project from the First Affiliated Hospital of Wannan Medical College (No. YR202227).  \nWritten informed consent for publication was obtained from all patients and their families included in this retrospective analysis.  \nThe authors have no conflicts of interest to disclose.  \nThe datasets generated during and/or analyzed during the current study are available from the corresponding author on reasonable request. a Department of Ultrasound, Second People’s Hospital of Jingdezhen City, Jingdezhen, Jiangxi Province, China.  \n* Correspondence: Zhen He, Department of Ultrasound, Second People’s Hospital of Jingdezhen City, No. 35 Guangchang North Road, Zhushan District, Jingdezhen 333000, Jiangxi Province, China ([e-mail: hz0709sh@16","cbCaigbqDl5o9uEp","https://ap.wps.com/l/cbCaigbqDl5o9uEp","pdf",516049,"English","# Abstract\n# Abbreviations\n# Keywords\n# Introduction","[{\"question\":\"What clinical problem does the study address?\",\"answer\":\"It addresses how ultrasonographic parameters may influence sampling adequacy and cytologic classification accuracy in ultrasound-guided fine-needle aspiration for thyroid nodules.\"},{\"question\":\"How was diagnostic accuracy evaluated?\",\"answer\":\"SWE-guided US-FNA targeted the stiffest intranodular region, and surgical histopathology served as the reference standard. Accuracy agreement was quantified using Kappa and odds ratios from logistic regression.\"},{\"question\":\"Which ultrasound factors were associated with reduced diagnostic accuracy?\",\"answer\":\"Multivariable analysis showed reduced diagnostic accuracy with nodule diameter \\u003c10 mm, intranodular calcification, and cystic component \\u003e50%.\"}]","Ultrasound parameters affecting the diagnostic accuracy of ultrasound-guided fine-needle aspiration for thyroid nodules - Observational Study | PDF",1790730698,15]