Gastroparesis (GP) is a gastric motility disorder characterized by delayed gastric emptying in the absence of mechanical obstruction. This expert consensus covers aspects of GP etiology (diabetes, surgery, drug-induced, idiopathic, scleroderma, etc.), symptomatology, diagnosis (scintigraphic imaging, ultrasound contrast meal assessment, and radiopaque marker gastric motility testing), and treatment (pharmacological therapy, nutritional support, traditional Chinese medicine, and interventions targeting the pylorus, such as endoscopic surgery and surgical procedures). GP significantly impacts patients' psychological well-being and quality of life, potentially leading to psychological disorders such as anxiety and depression, and also imposes a heavy economic burden on patients and society. Therefore, this expert consensus advocates for the establishment of a multidisciplinary team diagnosis and treatment model, which will further standardize and optimize the diagnosis and treatment process of GP in our country and is crucial for improving patients' therapeutic outcomes and quality of life.

Background This study compared long-term outcomes of ultrasound-guided radiofrequency ablation versus total thyroidectomy for bilateral multifocal (≤3) T1N0M0 papillary thyroid carcinoma. Methods In this retrospective cohort study, 125 patients with bilateral multifocal T1N0M0 papillary thyroid carcinoma treated between June 2018 and August 2020 were consecutively included. Among them, 55 underwent radiofrequency ablation and 70 underwent total thyroidectomy. All patients underwent total thyroidectomy with prophylactic central neck dissection. Outcomes included tumor progression, complications, costs, and quality of life. Results After a mean follow-up of 69.3 ± 6.9 months in the radiofrequency ablation group and 66.8 ± 7.9 months in the total thyroidectomy group, the tumor progression rates of the 2 groups were 7.3% and 2.9%, and the study was severely underpowered (16%) to detect a difference in recurrence. Compared with the total thyroidectomy group, the radiofrequency ablation group demonstrated significant advantages in hospital stay (0 day vs 7 days, P< .001), procedure time (16.5 min vs 90 min; P< .001), intraoperative blood loss (0 vs 20 mL; P< .001), procedure cost (¥15,877.1 vs ¥5,065.4; P< .001), complication rate (0% vs 25.7%; P< .001), and quality-of-life scores (13.1 vs 14.8; P< .001). No significant predictors of tumor progression were identified from the clinical or sonographic characteristics of the dominant lesions. Conclusion For selected patients with bilateral multifocal (≤3) T1N0M0 papillary thyroid carcinoma, radiofrequency ablation appears to be a promising minimally invasive option, associated with less trauma, lower cost, fewer complications, and better life quality.

ABSTRACT Background The similar imaging characteristics of renal angiomyolipoma without visible fat (RAML.wvf) and clear cell renal cell carcinoma (ccRCC) are notable. Color Parameter Imaging (CPI) has emerged as an advanced contrast‐enhanced ultrasound (CEUS) analysis tool that quantifies temporal perfusion dynamics. Objective Evaluate the diagnostic value of CPI in distinguishing AML.wovf from ccRCC. Methods In this prospective study, 88 patients (35 with AML and 53 with ccRCC) underwent CEUS and CPI. Junior and senior radiologists independently analyzed the CEUS and CPI images. Three diagnostic approaches were compared: (1) CPI alone, (2) CEUS alone, and (3) CEUS combined with CPI. The diagnostic sensitivity, specificity, accuracy, and receiver operating characteristic (ROC) curves of resident and staff radiologists were analyzed. Results The CPI features of ccRCC and AML.wovf analyzed by the junior and senior radiologist groups showed significant differences: the mosaic sign and the Cold sign (both p < 0.001) were more indicative of AML.wovf, whereas the Warm sign was more suggestive of ccRCC (both p < 0.05). The area under the curve (AUC) for the combined CEUS+CPI diagnosis in the junior radiologist group was higher than that for CEUS alone (p = 0.012). Regarding diagnostic confidence between the two radiologist groups, the proportion of uncertain cases in the CPI group was significantly lower than in the CEUS group for both the senior radiologist group and the junior radiologist group (both p < 0.05). Conclusion CPI technology can enhance the diagnostic performance of contrast‐enhanced ultrasound in differentiating ccRCC from AML.wovf, particularly offering an advantage in improving the diagnostic accuracy of junior radiologists.

OBJECTIVE:To evaluate the clinical outcomes of thermal ablation (TA) for subcapsular papillary thyroid microcarcinoma (PTMC) and compared them with those of intraparenchymal PTMC. METHODS:Patients with unifocal, clinical node-negative PTMC who underwent TA at three institutions between July 2015 and December 2021 were enrolled. Patients were divided into the subcapsular group (PTMC ≤ 2 mm from the capsule) and the intraparenchymal group (PTMC > 2 mm from the capsule). Propensity score matching (PSM) was used to balance between-group confounders. Primary outcomes were disease progression and disease-free survival (DFS); secondary outcomes included post-ablation lesion volume, volume reduction rate (VRR), cumulative tumor disappearance rate, and complications. RESULTS:A total of 209 and 288 patients were included in the subcapsular and intraparenchymal groups, respectively. During a mean follow-up of 48.4 months, the overall disease progression was 3.4%. Multivariate Cox regression analysis showed no association between subcapsular location and disease progression after adjusting for tumor volume, thyroid-stimulating hormone level, and ablation modality (HR = 1.3 [0.5, 3.5], p = 0.59). After 1:1 PSM, no significant differences between the subcapsular and intraparenchymal groups were observed in primary outcomes (disease progression: 4.3% vs. 3.8%; 5-year DFS rate: 93.2% vs. 93.9%, p = 0.82) or secondary outcomes (complication rate: 1.6% vs. 1.1%; latest volume: 0 mm³ vs. 0 mm³; latest VRR: 99.8% vs. 99.9%; cumulative tumor disappearance rate: 98.9% vs. 99.5%) (all p > 0.05). CONCLUSION:For eligible subcapsular PTMC patients, TA achieves 4-year clinical outcomes comparable to those of intraparenchymal PTMC cases, warranting further prospective investigations.

Repair of peripheral nerve injuries remains a major clinical challenge, motivating the development of bioelectroactive nerve guidance conduits (NGCs) capable of reconstructing the structural and electrophysiological microenvironment required for effective regeneration. Here, we report flexible bioelectroactive nerve guidance conduits (CPC-NGCs) that integrate mechanical compliance with efficient bioelectrical signal transmission, address challenges associated with the repair of peripheral nerve defects. These conduits are fabricated from chitosan, polyethylene oxide, and carbon nanotubes (CNTs) via electrospinning, forming a conductive nanofibrous network with a biomimetic fibrous architecture that supports peripheral nerve regeneration. By systematically regulating CNTs content, the hydrophilicity, conductivity, and mechanical properties of the conduits were optimized to achieve stable electrical performance and tissue adaptability. In vitro studies demonstrated that CPC-NGCs promoted PC12 cell viability, neurite extension, and neuronal differentiation. Electrical stimulation (ES) further enhanced neurite alignment and maturation-related marker expression. Moreover, the combination of CPC-NGCs and ES promoted Schwann cell elongation and maturation while modulating macrophage polarization toward a pro-regenerative M2 phenotype, thereby establishing a favorable microenvironment for nerve repair. In a 10 mm rat sciatic nerve defect model, electrically activated CPC-NGCs significantly enhanced axonal regeneration and remyelination, resulting in improved electrophysiological performance, sensory recovery, and motor functional restoration. Histological analyses further confirmed the reconstruction of structurally mature nerve tissue with reduced fibrosis. These findings demonstrate that the synergistic integration of biomimetic conductive conduits and electrical stimulation effectively promotes peripheral nerve regeneration through coordinated regulation of neuronal differentiation, Schwann cell maturation, and immune microenvironment remodeling.

OBJECTIVES:To compare the diagnostic efficacy of 3 imaging modalities-conventional ultrasound (US), contrast-enhanced ultrasound (CEUS), and their combination (US + CEUS)-among physicians with varying experience levels in diagnosing breast intraductal lesions and to elucidate the adjunctive value of CEUS. METHODS:This study included patients who underwent both US and CEUS for breast lesions and were subsequently pathologically confirmed to have intraductal breast lesions between January 2022 and September 2025. Using pathological findings as the gold standard, the efficacy of senior, mid-career, and junior physicians in differentiating benign from malignant intraductal lesions was calculated and compared across the 3 diagnostic modalities. RESULTS:A total of 205 cases were included, comprising 117 benign and 88 malignant lesions. The combined US + CEUS approach demonstrated significantly superior diagnostic efficacy and higher diagnostic confidence scores compared to either CEUS or US alone among physicians at all experience levels. The combined modality yielded optimal efficacy in the senior physician group (p < .001), while the magnitude of improvement was greatest among junior physicians (p < .001), particularly for easily missed lesions like atypical ductal hyperplasia (ADH) and ductal carcinoma in situ (DCIS). For any given examination protocol, diagnostic efficacy exhibited a declining trend with decreasing physician experience (p < .05). CONCLUSION:CEUS serves as a valuable adjunctive tool for diagnosing breast intraductal lesions and is particularly beneficial for junior and mid-career physicians. The combined diagnostic approach enhances overall diagnostic performance.

Objective To explore the clinical value of Automated Breast Ultrasound System (ABUS) combined with two-dimensional ultrasound for intraductal breast lesions, and to provide imaging evidence for preoperative benign and malignant differentiation. Methods Patients with pathologically confirmed intraductal breast lesions hospitalized in our hospital from April 2025 to April 2026 were enrolled. All subjects underwent two-dimensional ultrasound and ABUS examination. Ultrasonographic features were compared between benign and malignant groups. Univariate and multivariate logistic regression were used to screen independent risk factors of malignant lesions and establish a combined diagnostic model. ROC curves were drawn to compare the diagnostic efficiency of different detection schemes. Results A total of 200 patients were enrolled, including 132 benign cases and 68 malignant cases. The malignant group had significantly higher incidences of irregular shape, microcalcification, abundant blood flow, duct dilatation ≥ 5 mm, convergence sign, nipple-oriented lesion extension and marginal spiculation or angulation (P < 0.05). Multivariate logistic regression confirmed seven independent risk factors for malignancy (P < 0.05): irregular lesion morphology, microcalcification, Adler grade II–III blood flow, duct dilatation ≥ 5 mm, convergence sign, lesion extending toward the nipple and spiculation/angulation. The combined model had an AUC of 0.90, superior to standalone two-dimensional ultrasound (AUC = 0.81) and single ABUS (AUC = 0.86), with sensitivity of 90.7% and specificity of 89.2%. Conclusion Combination of ABUS and two-dimensional ultrasound has prominent clinical value for differentiating benign and malignant intraductal breast lesions, which improves preoperative diagnostic accuracy and facilitates clinical decision-making.

Artificial intelligence research in image-guided oncology has grown exponentially, yet how far the field has progressed from diagnostic assistance toward direct therapeutic execution has never been quantified. Existing bibliometric surveys categorize studies by technical architecture or clinical domain, metrics that track publication volume but not proximity to procedural deployment. We developed a hierarchical functional classification framework to map the global landscape of therapeutic AI development across five major oncological indications. Our two specific objectives were: (1) to classify publications by clinical output function along the diagnostic-to-therapeutic continuum, and (2) to quantify the translation gap using three complementary metrics, triangulated against trial and device registries. We extracted 29,277 Web of Science publications spanning five image-guided oncologic specialties (thyroid, breast, lung, prostate, and liver) published between January 2010 and April 2026. AI-related records were classified by clinical function using a three-stage protocol: keyword categorization, contextual scoring, and rule-based filtering. Inter-rater reliability, validated on 518 independently coded publications, yielded Cohen's κ of 0.92. Our framework distinguished Diagnosis AI (disease identification) from therapeutic AI, then further stratified therapeutic AI into Bridge-support AI (treatment planning, prognosis, patient selection) and True Treatment AI. True Treatment AI was defined by concurrent satisfaction of two criteria: ≥Level 2 on the Yang Surgical Autonomy Scale and ≥Stage 1 on the IDEAL Framework. Of 16,937 AI-related publications identified, 14,277 (84.3%) were categorized as Diagnosis AI and only 2,660 (15.7%) as therapeutic AI. All therapeutic publications fell exclusively within the Bridge-support tier. None satisfied the dual-framework criteria for True Treatment AI, yielding a uniform penetration rate of 0.00% across all five oncological domains. This complete execution vacuum persisted despite an 11-fold variation in inter-domain treatment-to-diagnosis ratios. The finding held under threshold relaxation, sensitivity analyses, and independent triangulation against 3,491 ClinicalTrials.gov records and 1,430 FDA device listings. Each specialty should periodically profile its diagnostic-to-therapeutic translational progress. The uniform absence of True Treatment AI across 15 years and five domains indicates that this gap is structural rather than cumulative, rooted in methodological inheritance from diagnostic paradigms and in regulatory category mismatches. Closing this gap requires coordinated framework development across regulatory, research, and clinical communities, rather than incremental algorithmic improvements.

Objectives To compare the diagnostic efficacy of 3 imaging modalities—conventional ultrasound (US), contrast‐enhanced ultrasound (CEUS), and their combination (US + CEUS)—among physicians with varying experience levels in diagnosing breast intraductal lesions and to elucidate the adjunctive value of CEUS. Methods This study included patients who underwent both US and CEUS for breast lesions and were subsequently pathologically confirmed to have intraductal breast lesions between January 2022 and September 2025. Using pathological findings as the gold standard, the efficacy of senior, mid‐career, and junior physicians in differentiating benign from malignant intraductal lesions was calculated and compared across the 3 diagnostic modalities. Results A total of 205 cases were included, comprising 117 benign and 88 malignant lesions. The combined US + CEUS approach demonstrated significantly superior diagnostic efficacy and higher diagnostic confidence scores compared to either CEUS or US alone among physicians at all experience levels. The combined modality yielded optimal efficacy in the senior physician group ( p < .001), while the magnitude of improvement was greatest among junior physicians ( p < .001), particularly for easily missed lesions like atypical ductal hyperplasia (ADH) and ductal carcinoma in situ (DCIS). For any given examination protocol, diagnostic efficacy exhibited a declining trend with decreasing physician experience ( p < .05). Conclusion CEUS serves as a valuable adjunctive tool for diagnosing breast intraductal lesions and is particularly beneficial for junior and mid‐career physicians. The combined diagnostic approach enhances overall diagnostic performance.

Objective: Ischemia reperfusion injury (IRI) accounts for approximately 60% of acute kidney injury (AKI), is the main pathophysiological mechanism driving the condition. This study evaluated whether in vivo ultrasound resolution microvascular (URM) imaging can quantify renal microcirculation and improve the diagnosis and treatment of AKI. Methods: Thirty male Sprague Dawley rats were allocated to control, sham, and IRI groups. After intravenous SonoVue injection (0.0225 mL/kg), URM images were acquired every 15 s for 2 min using a clinical ultrasound system (ULTIMUS 9E; VINNO). Microbubbles were localized and tracked on the ultrasound scanner using on-board analysis to generate quantitative microvascular maps. Serum biomarkers and histological analysis, including PAS staining and CD31 immunohistochemistry, evaluated AKI severity and vascular changes. Results: URM-derived perfusion index, mean density, and vessel ratio differed significantly among the IRI subgroups (L, M, H) and controls. Analysis of temporal dynamics identified a stable 30-60s acquisition window optimal for rat renal perfusion representation. These parameters showed strong correlation with histologically quantified vascular density, confirming their biological validity. Conclusion: URM imaging revealed renal microvascular alterations in AKI rats with high spatial resolution, and its quantitative indices correlated strongly with histological standards. Compared with contrast-enhanced ultrasound, URM more accurately distinguished graded AKI severity according to microvascular changes. The imaging window defined herein offers a standardized protocol for precise renal microcirculation assessment in preclinical studies.

Background:Routine lateral neck lymph node dissection in patients with medullary thyroid cancer (MTC) remains controversial. Therefore, we sought to develop a model to predict the risk of lateral neck lymph node metastasis (LLNM) in patients with MTC. Methods:This retrospective study analyzed the clinical, ultrasound, and radiomics features of patients who underwent surgery and were diagnosed with MTC in our hospital from 2014 to 2023. The main outcome was LLNM, for which three models were developed: conventional model based on clinical and ultrasound features, radiomics score (rad score) model, and nomogram model that combined clinical, ultrasound, and radiomics features. Internal validation was performed using the bootstrap method, and the results were compared. The performance was calculated using area under the receiver operating characteristic curve (AUC), calibration curve, and decision curve analysis. Results:There were 89 patients included, of whom 35 patients had LLNM. No significant associations were found between gender or age and LLNM (P>0.05). The increase in calcitonin (>539.7 pg/mL) was associated with the LLNM (P=0.07). Two preoperative ultrasound findings, subcapsular location and suspicious lateral lymph nodes on ultrasound, were associated with the LLNM (P<0.05). Five radiomics features were selected to develop the rad score model. The nomogram model had a higher AUC compared with the conventional model and rad score model (P=0.008, 0.01, respectively). Conclusions:This study developed a nomogram model that integrated clinical, ultrasound, and radiomics features that could be used to predict LLNM in patients with MTC.

BACKGROUND:The incidence of pancreatic lesions is increasing. However, there was limited study on the efficacy and safety of percutaneous ultrasound-guided core needle biopsy (US-CNB) for diagnosing pancreatic lesions. AIMS:This study aimed to evaluate the efficacy and safety of percutaneous US-CNB for diagnosing pancreatic lesions and to analyze the influencing factors. METHODS:Patients who underwent percutaneous US-CNB for pancreatic lesions from 2016 to 2025 were retrospectively analyzed, and their clinical, imaging, pancreatic biopsy-related data and pathological diagnosis were recorded; subsequently, 777 patients were included. The sensitivity, specificity, accuracy, positive predictive value (PPV), negative predictive value (NPV) of percutaneous US-CNB for diagnosing pancreatic lesions were calculated using surgical pathological findings or clinical diagnoses as the gold standard. Factors affecting accuracy were screened using univariate and logistic regression analyses. RESULTS:In total, 796 ultrasound-guided biopsies were successfully performed in 777 patients. Biopsy results were consistent with the final diagnosis in 753 cases (consistent group) and inconsistent in 43 cases (inconsistent group). The sensitivity, specificity, accuracy, PPV, and NPV were 94.99% (644/678), 92.37% (109/118), 94.60% (753/796), 98.62% (644/653), and 76.22% (109/143), respectively. Mild complications occurred in eight cases (8/796, 1.00%), and severe complications, in seven cases (7/796, 0.88%), which resolved on their own or with treatment. The tumor markers, location of lesion for biopsy, and longest diameter of the lesion were significant factors between groups (p < 0.05). Multivariate regression analysis showed that lesion location (p = 0.018) was an independent factor affecting diagnostic efficacy. CONCLUSION:Percutaneous US-CNB is safe and reliable for diagnosing pancreatic lesions, and its accuracy is better for diagnosing pancreatic body and tail lesions.

Background US-guided tube thoracostomy (US-TT) is widely employed for pleural effusion management, however bleeding complications remain a clinical concern.Objective To identify risk factors for bleeding during US-TT, focusing on doctor experience, coagulation status, malignancy, and anticoagulant/antiplatelet medication use.Methods In this retrospective cohort study, we analyzed 4,073 patients undergoing US-TT between January 2019 and January 2024. Using univariate analysis and multivariate binary logistic regression, we evaluated associations between post-procedural bleeding and the following factors: coagulation parameters (PLT, INR, APTT), inflammatory markers, use of anticoagulant/antiplatelet medications, malignancy status, and doctor experience (junior vs. senior). Demographic and clinical data were extracted from electronic medical records.Results Bleeding occurred in 24 patients (0.6%). Univariate analysis identified procedure performance by junior physicians and presence of malignancy as significant risk factors (P < 0.05). No significant associations were found with coagulation parameters, inflammatory markers, or medication use. Factors with P < 0.1 (junior doctor, malignancy, INR > 2.0, elevated leukocyte count) were included in multivariate analysis. This confirmed junior doctor status (OR, 3.333; P = 0.033) and malignancy (OR, 3.960; P = 0.016) as independent predictors of bleeding.Conclusions US-TT carries a low overall bleeding risk (0.6%). In this study, bleeding was associated with malignancy and less experienced doctors, but not significantly with routine coagulation indices. A trend toward increased risk with INR > 2.0 warrants caution.

Background Given the current inconsistency in thyroid nodule diagnostic classifications, this study aimed to compare the diagnostic performance between conventional US based and contrast enhanced ultrasound (CEUS) integrated systems, as well as among systems within each category, and to identify the most clinically practical thyroid imaging reporting and data system (TI-RADS). Methods This retrospective study included patients who underwent conventional US, CEUS and fine-needle aspiration (FNA) between January 2023 and January 2025. Nodules were classified using three conventional US-based TI-RADS (ACR-TIRADS, EU-TIRADS, Modified Kwak TI-RADS) and five CEUS-integrated TI-RADS (CEUS1-5) recently reported in the literature, which were modified from US TI-RADS by incorporating CEUS features. Comparisons of diagnostic performance within and between the two categories were conducted using pathology as the reference standard. Results A total of 319 thyroid nodules from 268 patients were included, comprising 120 benign and 199 malignant. CEUS-integrated systems demonstrated superior diagnostic performance compared with conventional TI-RADS, with significantly higher AUC values (0.78–0.88 vs. 0.76–0.77, P < 0.01). Among CEUS-integrated systems, CEUS-1 and CEUS-5 achieved the same highest AUC (0.88) and accuracy (0.80). Using the optimal cut-off values (TR4b), CEUS-5 demonstrated superior Youden index (0.65; 95% CI: 0.57–0.73), specificity (0.93; 95% CI: 0.89–0.97) and positive predictive value (0.95; 95% CI: 0.91–0.98), CEUS-1 offered a balanced performance (sensitivity 0.76, 95% CI: 0.70–0.82; specificity 0.87, 95% CI: 0.80–0.92). CEUS-5 showed 0% malignancy in its lowest risk category and a peak malignancy rate exceeding 95% in its highest risk category, with Spearman correlation analysis revealing a nearly perfect correlation between its risk scores and malignancy ( P < 0.01). Consistency metrics (F1 score, κ, MCC) were also highest for CEUS-1 (0.83, 0.59, 0.61) and CEUS-5 (0.82, 0.60, 0.63), confirming their robust predictive performance. Conclusion CEUS-integrated systems significantly outperform conventional TI-RADS in thyroid nodule risk stratification, with CEUS-1 and CEUS-5 achieving the highest diagnostic performance in terms of AUC. CEUS-5 further demonstrated superior performance across additonal diagnostic metrics, especially Youden index and specificity, representing a more refined and promising tool for clinical implementation.

Backgrounds Assessment of median nerve (MN) microvascularity is critical for early diagnosis of neuropathy, yet conventional techniques like color Doppler flow imaging (CDFI) lack sensitivity for small vessels, while contrast-enhanced ultrasound (CEUS) is invasive. Angio Planewave Ultrasensitive imaging (AP), a novel non-invasive modality, offers high-resolution microvascular visualization, but its application in MN vascularity remains unexplored. Objectives To determine the feasibility of Angio Planewave Ultrasensitive imaging (AP) in comparison with color Doppler flow imaging (CDFI) for detection of median nerve (MN) vascularity in healthy volunteers and to explore the correlation between the blood flow distribution of MN on AP and the clinical parameters. Methods 30 healthy volunteers were prospectively enrolled in our study. CDFI and AP were performed to evaluate the vascularity of MN in the wrist level and the mid-forearm level. MN vascularity using Adler's grading on CDFI and AP were compared, and a new classification of vascular distribution was proposed. Two radiologists performed image review for evaluation of intra- and interobserver agreements. The new vascular types in the wrist level and the mid-forearm level were compared. The correlation of clinical parameters and the new vascular types were analyzed. Results AP was more sensitive in displaying the vascularity of MN compared with CDFI (p < 0.0001), presenting excellent intra- and inter-observer agreements (k > 0.90) based on the new vascular types. Type I and type II were most frequently detected in the wrist level and the mid-forearm level respectively. There was a weak correlation between the cross-sectional area and vascular distribution at the wrist level and the mid-forearm level (r = 0.290, r = 0.304 respectively, both p < 0.05). Conclusions AP demonstrated superior sensitivity in visualizing MN vascularity compared to CDFI, with excellent intra- and inter-observer reproducibility using the proposed vascular classification. These findings provide a critical technical foundation for future studies exploring vascular changes in neuropathies and their correlation with clinical outcomes.

OBJECTIVE:To evaluate the efficacy and safety of ultrasound-guided thermal ablation (TA)for the treatment of T1N0M0 papillary thyroid carcinoma (PTC) in adolescent patients. METHODS:This retrospective study enrolled adolescent patients with solitary T1N0M0 PTC who underwent TA between January 2015 and January 2025. Patients were stratified into T1a and T1b subgroups based on maximum tumor diameter. The primary outcomes were tumor progression rate and progression-free survival (PFS); secondary outcomes included ablation zone volume dynamics, volume reduction rate, complications, thyroid function, and patient-reported satisfaction. RESULTS:A total of 82 patients were included (56 in T1a group, 26 in T1b group), with a technical success rate of 100%. The overall median follow-up duration was 36 months (interquartile range [IQR]: 24-60 months). Ablation zone volumes progressively decreased and eventually vanished in all cases. The median time to complete disappearance of the ablation zone was significantly longer in the T1b group than in the T1a group (18 months vs. 12 months, p = 0.014). The overall tumor progression rate was 2.4% (2/82), with no significant difference between subgroups (p = 0.579). Progression-free survival (PFS) rates were comparable between T1a and T1b groups (96.5% vs. 94.0%, p = 0.550). No major complications occurred. CONCLUSION:Ultrasound-guided TA is a safe and effective treatment modality for both T1a and T1b subgroups of adolescent patients with solitary T1N0M0 PTC.

OBJECTIVES:To compare the efficacy of thermal ablation (TA) with thyroid lobectomy (TL) for clinical node-negative subcapsular papillary thyroid microcarcinoma (PTMC) and to assess the impact of occult lymph node metastasis (LNM) or pathologic local invasion on clinical outcomes. METHODS:This retrospective study was conducted at 3 referral centers. It included patients with unifocal clinical node-negative subcapsular PTMC who underwent TA (n = 536) or TL (n = 740) from June 2014 to December 2020. The TL group was divided into occult LNM-positive, occult LNM-negative, pathologic local invasion-positive, and pathologic local invasion-negative subgroups based on pathologic findings. Propensity score matching and inverse probability of treatment weighting were used to control for potential confounders. Primary outcomes were disease progression and progression-free survival (PFS). Secondary outcomes included complications and treatment parameters. RESULTS:The median follow-up duration of the primary cohort was 60.1 (42.0) months. After propensity score matching (519 patients per group), no significant differences were observed in disease progression rates (4.0% vs 2.7%) or 5-year PFS rates (95.8% vs 97.2%) between the TA and TL groups (P > .05). After inverse probability of treatment weighting, the TA group exhibited no significant difference in PFS rates compared to the occult LNM-positive (P = .97) or the pathologic local invasion-positive (P = .66) subgroups. Additionally, TA was associated with lower complication rates compared with TL (0.4% vs 2.1%, P = .01) CONCLUSIONS: In eligible patients with subcapsular PTMC, TA and TL exhibit comparable 5-year disease progression rates and PFS rates. TA may be an alternative option for eligible patients with subcapsular PTMC who are ineligible for or refuse lobectomy.

To investigate the clinical value of Doppler ultrasound in the rapid evaluation of therapeutic efficacy of angioplasty and prediction of recurrence in patients with Budd–Chiari syndrome (BCS). A retrospective study was conducted on BCS patients who underwent angioplasty at our hospital between January 2015 and December 2024. Ultrasound examinations were performed preoperatively and within 7 days postoperatively to compare changes in ultrasound parameters. Follow-up ultrasounds were conducted postoperatively. Differences in ultrasound parameters between recurrence and non-recurrence groups were analyzed to identify indicators for the rapid evaluation of recurrence. Cox regression analysis was used to identify independent risk factors for recurrence. A total of 99 patients (51 males, 48 females; mean age 39.38 ± 12.20 years) were included. Postoperative ultrasound showed significant increases in portal vein (PV) diameter (p = 0.019) and velocity (p < 0.001), while caudate lobe thickness (p = 0.016), spleen length (p = 0.004), spleen thickness (p = 0.012), and ascites depth (p < 0.001) decreased. During follow-up, PV velocity slightly decreased in the non-recurrence group (25.1 cm/s vs 28.3 cm/s, p = 0.018), while it significantly declined in the recurrence group (21.4 cm/s vs 30.2 cm/s, p < 0.001). The median velocity decline was greater in the recurrence group (−7 cm/s vs −1 cm/s, p = 0.003). Multivariate Cox regression identified postoperative paraumbilical vein dilation (HR: 2.970, 95

OBJECTIVE:To assess the long-term efficacy of ultrasound-guided radiofrequency ablation (RFA) and microwave ablation (MWA) in treating benign thyroid nodules (BTNs) and to establish a nomogram predicting post-ablation regrowth. METHODS:This multi-center retrospective study included 611 patients with 753 BTNs treated by thermal ablation and followed for ≥24 months. Linear regression was used to identify factors affecting volume reduction rate (VRR). Univariate and multivariate Cox regression were performed to determine predictors of regrowth, which were incorporated into a predictive nomogram validated by calibration, concordance index (C-index), ROC, and decision curve analysis (DCA). RESULTS:All BTNs with a median follow-up of 36 months, nodules showed progressive shrinkage, with VRR >75% at 12 months and stabilizing near 90% by 24 months. At 60 months, the median VRR was 88.46%, with no significant difference between MWA and RFA (p > 0.05). Regrowth occurred in 6.51% (49/753) of nodules, and most were successfully retreated. Baseline maximum diameter was the only factor associated with VRR (p = 0.014). Independent predictors of regrowth included age (HR = 0.951, 95% CI: 0.909-0.994), baseline maximum diameter (HR = 1.628, 95% CI: 1.112-2.382), and energy per unit volume (HR = 0.994, 95% CI: 0.991-0.997). The nomogram demonstrated excellent performance (C-index 0.908 training, 0.792 validation), with calibration, ROC, and DCA confirming predictive accuracy and clinical utility. CONCLUSION:RFA and MWA demonstrated durable long-term efficacy and favorable safety profiles in the treatment of BTNs, with approximately 6% of nodules developing regrowth during follow-up. A nanogram is established to predict the regrowth risk.

BACKGROUND:Lymph nodes are critical immune system components, filtering harmful substances and acting as indicators in various disease states, including cancer. Accurate differentiation between benign and malignant superficial lymph nodes is essential for diagnosis and treatment planning. However, conventional diagnostic methods often lack the required precision. High-frequency contrast-enhanced ultrasound (H-CEUS) offers improved temporal resolution and visualization of microvascular structures, potentially providing better diagnostic accuracy than standard contrast-enhanced ultrasound (CEUS). METHODS:This study included 77 patients with suspected abnormalities in superficial lymph nodes. Each patient underwent H-CEUS and CEUS examinations, with diagnoses confirmed through biopsy or surgical resection. The diagnostic performance of H-CEUS and CEUS was evaluated using sensitivity, specificity, positive predictive value, negative predictive value, and accuracy. Chi-square tests and ROC curve analysis were employed to compare the efficacy of H-CEUS and CEUS in differentiating benign from malignant lymph nodes. RESULTS:H-CEUS demonstrated superior diagnostic performance over CEUS, with higher sensitivity (95.92% vs. 83.67%), specificity (92.86% vs. 57.14%), and accuracy (94.80% vs. 74.03%). H-CEUS enhanced microvascular morphology visualization, facilitating more accurate differentiation between benign and metastatic lymph nodes. The area under the ROC curve for H-CEUS (0.944) was significantly greater than that for CEUS (0.704), indicating improved diagnostic capability. CONCLUSION:H-CEUS offers enhanced accuracy in diagnosing the nature of superficial lymph nodes, potentially improving clinical decision-making for patients with suspected lymph node malignancies. These findings support the integration of H-CEUS into routine clinical practice to achieve better diagnostic outcomes.