In middle-aged and older atherosclerotic renal artery stenosis (ARAS), the anatomical severity of stenosis is a poor surrogate for microvascular competence, and the renal benefit of revascularization is unpredictable. We developed Renal-Video-AI, a self-supervised deep learning framework (Video Swin Transformer with VideoMAE pretraining) that extracts spatiotemporal hemodynamic features from contrast-enhanced ultrasound, and applied it to a multi-center Discovery Cohort (N = 1,226), an independent External Validation Cohort (N = 122), a prospective Multimodal Cohort with paired 10x Visium spatial transcriptomics (N = 57), and an aged two-kidney-one-clip (2K1C) murine model. Unsupervised phenomapping identified 3 intrinsic hemodynamic phenotypes—Preserved, Delayed, and Rarefied. The Rarefied phenotype predicted major adverse renal events (MAREs) independently of anatomical stenosis [hazard ratio (HR) 4.82, 95% confidence interval (CI) 3.10 to 6.50; Fine–Gray subdistribution HR (sHR) 5.1], and adding the phenotype to a standard clinical model improved the C-statistic from 0.72 to 0.88. A significant phenotype-by-treatment interaction (P < 0.01) showed that stenting reduced events only in the Delayed phenotype (HR 0.52, 95% CI 0.35 to 0.78), not in the Preserved (HR 0.98) or Rarefied (HR 1.05) phenotypes. In absolute terms, stenting reduced the 3-year cumulative incidence of MARE in the Delayed phenotype from 25.4% to 13.2% (absolute risk reduction 12.2%; number needed to treat = 8, 95% CI 6 to 13), with no benefit in the Preserved (8.4% versus 8.0%) or Rarefied (38.6% versus 39.4%) phenotypes. Spatial transcriptomics localized a hypoxia and pyroptosis signature to rarefied tissue, and the aged 2K1C model revealed a mitochondrial reactive oxygen species (ROS)–NLRP3–pyroptosis axis whose pharmacological inhibition (MCC950) restored microvascular perfusion. AI video-phenomapping thus reframes the revascularization decision around microvascular competence rather than anatomy, identifying both therapeutic futility (Rarefied) and a treatable window (Delayed), and nominates NLRP3-driven pyroptosis as a therapeutic target.

Background: Whether BRAF V600E positivity should preclude radiofrequency ablation (RFA) in otherwise suitable patients with cT1N0M0 papillary thyroid carcinoma (PTC) remains unclear. This study aimed to explore the association between BRAF V600E status and structural recurrence/metastasis after RFA. Methods: We retrospectively included 433 consecutive patients with cT1N0M0 PTC who underwent initial ultrasound-guided RFA between May 25, 2021, and May 31, 2025. All patients had preablation BRAF V600E testing performed on fine-needle aspiration specimens and valid follow-up. The primary endpoint was structural recurrence/metastasis after technically complete ablation. Sparse-event, Bayesian, time-adjusted, and sensitivity analyses were performed. Results: Among 433 patients, 215 were BRAF V600E positive and 218 were negative. During a median follow-up of 14.3 months, structural recurrence/metastasis occurred in 3 patients, all in the BRAF V600E -positive group. The event rate was 1.40% versus 0.00%, and the corrected odds ratio was 7.20, with a wide 95% confidence interval of 0.37 to 140.19. Bayesian analysis showed a posterior probability of 0.968 that the risk difference was greater than zero. The signal remained directionally consistent across sensitivity analyses but was limited by the small number of events. Events were not concentrated in the high sonographic anatomic complexity stratum. No higher recorded complication burden was observed in BRAF V600E -positive patients. Conclusions: BRAF V600E positivity identified the subgroup in which structural events occurred after RFA, but it did not by itself establish procedural unsuitability. In selected cT1N0M0 PTC patients, BRAF V600E status may be better used to guide counseling and follow-up intensity than as an absolute exclusion criterion for RFA. Trial registration: Not applicable.

The incidence of thyroid cancer keeps rising globally,with the majority being papillary thyroid carcinoma (PTC),which has a favorable prognosis.However,some aggressive PTCs exhibit different clinical behaviors and higher mortality risks,with the growth rate surpassing that of well-differentiated PTC and undifferentiated cancers.Therefore,achieving precise diagnosis and treatment of thyroid carcinoma presents a significant challenge.Photoacoustic imaging is a molecular imaging technology that integrates optical imaging and ultrasound,providing imaging information on structure,function,and molecules.Moreover,it can utilize exogenous contrast agents to realize tumor treatment,such as photothermal therapy,serving as a promising technology for precise diagnosis and treatment of thyroid carcinoma.Researchers both domestically and internationally have explored the application of photoacoustic imaging in the precise diagnosis and treatment of thyroid tumors.This article reviews the research progress,elucidates the advantages and limitations of photoacoustic imaging in the diagnosis and treatment of thyroid carcinoma,and prospects on the precise diagnosis and treatment of this disease.

Background Differentiated thyroid cancer (DTC) accounts for the majority of thyroid cancers. The preoperative diagnosis of extrathyroidal extension (ETE) in DTC patients is highly important. However, two-dimensional ultrasound (2D-US) has several limitations in diagnosing ETE. This study aimed to evaluate the efficiency of OmniView of three-dimensional ultrasound (3D-OmniView) in assessing the ETE of DTC patients compared with that of 2D-US. Methods Patients who underwent thyroid surgery for nodules adjacent to the thyroid capsule between February 2016 and January 2018 were prospectively enrolled in this study. Both 2D-US and 3D-OmniView were used to evaluate ETE of thyroid nodules. The definition for ETE in ultrasound images was capsule disruption, or capsule disruption and surrounding tissue invasion. Intraoperative and pathological findings of ETE were considered positive. The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), accuracy, and area under the ROC curve (AUC) were calculated. Results A total of 176 DTC nodules from 137 patients were included in this study. ETE was identified in 67.0% of the nodules. The sensitivity, accuracy, NPV and AUC of 3D-OmniView for predicting ETE were significantly greater than those of 2D-US. The sensitivity and specificity of 2D-US and 3D-OmniView were 79.7% and 51.7%, respectively (P < 0.001), and 81.0% and 82.8%, respectively (P = 0.776). Both 2D-US and 3D-OmniView showed better efficacy in evaluating ETE in nodules > 1 cm than in evaluating ETE in nodules ≤ 1 cm. Conclusion 3D-OmniView was more precise in predicting ETE of DTC nodules than 2D-US. 3D-OmniView is recommended for further evaluation of suspicious ETE. ETE was easier to detect by ultrasound for nodules > 1 cm than for nodules ≤ 1 cm.

CONTEXT:Thyroid nodules with intermediate- and low-suspicion patterns are difficult to diagnose, based on the 2015 American Thyroid Association (ATA) stratification. AIMS:We evaluated the performance of shear wave elastography (SWE) as an adjunctive tool to ultrasound (US) in predicting the malignancy of these thyroid nodules. SETTINGS AND DESIGN:Thyroid nodules (n = 270) collected from January to April 2018 with low or intermediate suspicion for malignancy were evaluated. METHODS, MATERIALS, AND STATISTICAL ANALYSES:The maximum SWE elasticity values (Emax) for the nodules were examined and subsequently confirmed by pathology. SWE and ATA guidelines, as well as a combination of the two, were applied. RESULTS:Combined with SWE, the diagnostic accuracy of the ATA categories was superior to the ATA categories alone (area under the curve, AUC 0.81 vs. 0.72, P < 0.05). Based on the ATA categories, the percentages of malignancy in the nodules with low and intermediate suspicion for malignancy were 21.1% (12/57) and 54.2% (13/24), respectively. After adjustments for the use of SWE, the nodules were restratified as very low, low, intermediate, and high suspicion of malignancy. The percentages of malignancy for the very low, low, intermediate, and high suspicion nodules were 0 (0/26), 27.3% (3/11), 37.8% (12/31), and 76.9% (10/13), respectively. CONCLUSION:SWE may be used to differentiate malignant and benign nodules in addition to the ATA pattern. Combined with the ATA pattern, SWE supplemented US for predicting nodules with low and intermediate suspicion of malignancy.

Abstract Objectives To establish and validate a dual-modal radiomics nomogram from grayscale ultrasound and color doppler flow imaging (CDFI) of cervical lymph nodes (LNs), aiming to improve the diagnostic accuracy of metastatic LNs in differentiated thyroid carcinoma (DTC). Methods DTC patients with suspected cervical LNs in two medical centers were retrospectively enrolled. Pathological results were set as gold standard. We extracted radiomic characteristics from grayscale ultrasound and CDFI images, then applied lasso (least absolute shrinkage and selection operator) regression analysis to analyze radiomics features and calculate the rad-score. A nomogram based on rad-score, clinical data, and ultrasound signs was developed. The performance of the model was evaluated using AUC and calibration curve. We also assessed the model’s diagnostic ability in European Thyroid Association (ETA) indeterminate LNs. Results 377 DTC patients and 726 LNs were enrolled. 37 radiomics features were determined and calculated as rad-score. The dual-modal radiomics model showed good calibration capabilities. The radiomics model displayed higher diagnostic ability than the traditional ultrasound model in the training set [0.871 (95% CI: 0.839–0.904) vs. 0.848 (95% CI: 0.812–0.884), p<0.01], internal test set [0.804 (95% CI: 0.741–0.867) vs. 0.803 (95% CI: 0.74–0.866), p = 0.696], and external validation cohort [0.939 (95% CI: 0.893–0.984) vs. 0.921 (95% CI: 0.857–0.985), p = 0.026]. The radiomics model could also significantly improve the detection rate of metastatic LNs in the ETA indeterminate LN category. Conclusions The dual-modal radiomics nomogram can improve the diagnostic accuracy of metastatic LNs of DTC, especially for LNs in ETA indeterminate classification.

There is a continuous increase in the incidence of thyroid cancer. A deeper understanding of the molecular mechanisms of thyroid cancer could significantly improve thyroid cancer management. Newly discovered type of programmed cell death, ferroptosis, has been demonstrated to play a crucial role in many cancers. Mounting evidence shows that there is a close association between ferroptosis and thyroid cancer, which offer a promising therapeutic strategy for thyroid cancer. Ferroptosis is expected to emerge as a novel therapeutic target. Regrettably, the exact role of ferroptosis in thyroid cancer is not yet completely understood. Further, there is currently no summary of ferroptosis in thyroid cancer progression and treatment. Hence, in this review, we aim to revisit the pathological process of thyroid cancer and reveal the role of ferroptosis in thyroid cancer. In addition, we provide evidence that ferroptosis inducers could suppress the growth of thyroid cancer cells. Lastly, we discuss the potential application of ferroptosis inducers in thyroid cancer treatment, as well as possible impediments and corresponding strategies. The relationship between ferroptosis and thyroid cancer will be better understood through this review, which may offer a novel insight into thyroid cancer therapy.

Papillary thyroid carcinoma (PTC) is a prevalent endocrine malignancy with a propensity for lymph node metastasis (LNM). Extrathyroidal extension (ETE) is a key factor in preoperative LNM prediction. The criteria for ultrasound diagnosis of ETE remain controversial. The aim is to determine if the length of capsule disruption (LCD) on three-dimensional ultrasound (3D-US) can predict cervical LNM in PTC patients. A prospective cohort of 168 patients from Peking Union Medical College Hospital was examined by 3D-US. The LCD was measured using the omniview mode of 3D-US. Statistical analyses included Chi-square tests, T-tests, Mann–Whitney tests, ROC curve analysis, and logistic regression analysis. Of the 126 patients included, 71 had LNM. Younger age, male gender, larger malignant nodules, LCD, echogenic foci, and thyroid capsule invasion were significantly associated with LNM. LCD ≥ 0.42 cm increases LNM risk by 4.097 (p < 0.001). A nomogram was constructed incorporating gender, age, maximum diameter of the largest malignant nodule (MDLM), and LCD to estimate the risk of LNM. The accuracy and AUC of the nomogram were 73.0

OBJECTIVE:Tolvaptan is a vasopressin V2 receptor antagonist that is commonly prescribed to alleviate edema associated with renal diseases. However, the clinical benefits of tolvaptan in chronic kidney disease (CKD) remain unclear. This study aimed to evaluate the effectiveness of tolvaptan in managing edema caused by CKD. MATERIALS AND METHODS:The efficacy and treatment regimen of tolvaptan were assessed in a cohort of 96 patients with renal edema and CKD. During the treatment, the patients' creatinine (CR), uric acid (UA), and estimated glomerular filtration rate (eGFR) were monitored as important indicators of kidney function. Coagulation-associated molecules including fibrinogen, D-dimer, and fibrin degradation products (FDPs) were measured. Electrolyte disorders and acute kidney injury were closely monitored. Tolvaptan was administered at a daily dose of 7.5 mg, and 30 mg of edoxaban was administered to manage deep vein thrombosis. RESULTS:During the course of tolvaptan therapy, the eGFR of the patients was not declined. Edema was eliminated in 82.18% of patients. Proteinuria was reduced in the patients (p < 0.05). There were no significant changes in serum sodium levels throughout treatment, and no significant difference was observed in blood volume between the end of treatment and baseline levels. Importantly, acute kidney injury did not occur, and renal edema and deep vein thrombosis were successfully treated. CONCLUSION:As long as a rational treatment regimen is followed, tolvaptan is a safe and effective diuretic for treating edema in CKD, even in the late stages of CKD without reducing residual renal function in the patients.

Background:To report the occurrence of abdominal symptoms in patients who presented with prolonged heterogeneous liver enhancement (PHLE) after injecting contrast agent SonoVue®.Methods:A total of 105 patients who indicated to have contrast-enhanced ultrasound (CEUS) examinations were consecutively observed. The liver scanning under ultrasound was performed before and after the contrast agent injection. Patients' basic information, clinical manifestations, and ultrasound images under B-mode and CEUS mode were respectively recorded. For patients exhibiting abdominal symptoms, the occurrence and last time of symptoms were recorded in detail. We subsequently compared the difference in clinical characteristics between patients with and without the PHLE phenomenon.Results:In 20 patients with the PHLE phenomenon, 13 showed abdominal symptoms. Eight patients (61.5%) appeared to have mild defecation sensation, and 5 (38.5%) showed apparent abdominal pain. The PHLE phenomenon began to appear within 15 minutes to 1.5 hours after the intravenous injection of SonoVue®. This phenomenon lasted for 30 minutes to 5 hours in ultrasound. Patients with severe abdominal symptoms showed large-area and diffuse PHLE patterns. Only sparse hyperechoic spots in the liver were detected in patients with mild discomfort. Abdominal discomfort resolved spontaneously in all patients. Meanwhile, the PHLE gradually disappeared without any medical treatment. In the PHLE-positive group, the proportion of patients with a history of gastrointestinal disease was significantly higher (P=0.02).Conclusions:Patients with the PHLE phenomenon can exhibit abdominal symptoms. We suggest gastrointestinal disorders may contribute to PHLE, which can be considered a harmless phenomenon that does not affect the safety profile of SonoVue®.

Abstract Objective To explore the effect of quality control in the practice of lung ultrasound in residents. Methods A quality control system of lung ultrasound was established by developing a standardized scanning protocol, theoretical and operational training, and quality scores to evaluate the practical effects of 14 residents who participated in lung ultrasound examinations of hospitalized patients during the COVID-19 pandemic from December 2022 to January 2023. Results The average scores of according years of training for residents participating in lung ultrasonography gradually increased. Compared with the overall mean (7.73 ± 1.36 points), there was no statistically significant difference in the scores of first and second-year residents (7.41±1.58 points, 7.54±1.12 points, P > 0.05), and there was a statistically significant difference in the scores of third-year resident or above (8.79 ± 1.01 points, P< 0.05). First and second-year residents had problems such as too deep image depth, lack of body markers, and lack of some lung subdivisions. Conclusion The establishment of a lung ultrasound quality control system makes residents master lung ultrasound and join the clinical practice, especially in ensuring the quality of ultrasound examination for junior residents.

EDITORIAL article Front. Endocrinol., 17 May 2023Sec. Cancer Endocrinology Volume 14 - 2023 | https://doi.org/10.3389/fendo.2023.1214596

BACKGROUND:Thyroid nodules are increasingly treated with minimally invasive surgery. Thermal ablation could efficiently treat patients with benign thyroid nodules, recurrent thyroid cancer, and low-risk papillary thyroid carcinoma. This research aims to explore the research field of thermal ablation for thyroid nodules using bibliometric analysis.METHODS:The web of science core collection (WoSCC) database was utilized from its inception to 1 October 2022, to collect research articles and reviews on ultrasound-guided thermal ablation for thyroid nodules. We applied the R package 'bibliometrix' to summarize the main findings, calculate the occurrences of the top keywords and visualize the international collaboration networks. The co-authorship and co-occurrence analyses were conducted with VOSviewer software. CiteSpace was used to identify the top references and keywords with the highest citation bursts.RESULTS:A total of 820 publications from 32 countries were retrieved. The annual number of related publications showed an increasing trend. China, Italy, and Korea were the most contributing countries. The University of Ulsan College of Medicine in Korea was the most productive institution, and Jung Hwan Baek published the maximum number of articles. The International Journal of Hyperthermia was the most productive journal. 'Papillary thyroid micro-carcinoma (PTMC)' and 'association guideline' were the most frequently used keywords in the field of thermal ablation for thyroid nodules, which indicated the potential hot research topics and frontiers in the future.CONCLUSION:This bibliometric study conducts a comprehensive analysis of publications on thermal ablation for thyroid nodules, which aids investigators in discovering potential research directions.

BackgroundAccurate diagnosis of highly aggressive papillary thyroid cancer (PTC) may greatly help avoid overdiagnosis and overtreatment of PTC. However, there is still a lack of a convenient and accurate method. Targeted microbubbles, an emerging ultrasound contrast agent, have the potential to accurately diagnose highly aggressive PTC.PurposeTo design and prepare a targeted microbubble for specific contrast-enhanced ultrasound (CEUS) imaging of highly invasive PTC.MethodsUsing β-galactoside-binding protein galectin-3 (Gal-3) overexpressed on the surface of highly invasive PTC cells as a target, C12 polypeptide (ANTPCGPYTHDCPVKR) with high affinity and specificity for Gal-3 was coupled to the surface of lipid microbubbles to prepare targeted microbubbles (Gal-3-C12@lipo MBs). The targeted microbubbles were prepared by thin-film hydration method and mechanical shaking method. The morphology, diameter, concentration and stability of microbubbles were investigated by fluorescence microscopy and an AccuSizer. The biosafety of microbubbles was studied using BCPAP cells through CCK8 assay. Confocal laser scanning microscope and flow cytometry were applied to research the cellular uptake of microbubbles to investigate the targeting ability to highly aggressive PTC. Finally, the specific contrast-enhanced ultrasound imaging of microbubbles in highly invasive PTC was validated on the mice bearing subcutaneous BCPAP tumor model via a clinically ultrasound imaging system.ResultsGal-3-C12@lipo MBs were successfully prepared which showed a well-defined spherical morphology with an average diameter of 1.598 ± 0.848 μm. Gal-3-C12@lipo MBs showed good stability without rupture within 4 hours after preparation. At the cellular level, Gal-3-C12@lipo MBs exhibited favorable biosafety and superior targeting ability to BCPAP cells, with 2.8-fold higher cellular uptake than non-targeted lipid microbubbles (Lipo MBs). At the animal level, Gal-3-C12@lipo MBs significantly improved the quality of contrast-enhanced ultrasound imaging in highly invasive PTC, with an echo intensity of tumor significantly higher than that of Lipo MBs.ConclusionWe designed and fabricated a novel targeted microbubble for the specific ultrasound imaging diagnosis of highly aggressive PTC. The targeted microbubbles have good stability, superior biosafety and high targeting specificity, which can significantly improve the tumor signal-to-noise ratio of highly invasive PTC, and have the potential to facilitate and accurately diagnose highly invasive PTC.

Objective To investigate the influencing factors and establish a model predicting the performance of needle visualization in fine-needle aspiration (FNA) of thyroid nodules. Methods This study prospectively included 175 patients who underwent FNA of thyroid nodules in the Department of Ultrasound in China-Japan Friendship Hospital and compared the display of the needle tips in the examination of 199 thyroid nodules before and after the application of needle visualization.We recorded the location,the positional relationship with thyroid capsule,ultrasonic characteristics,and the distribution of the soft tissue strip structure at the puncture site of the nodules with unclear needle tips display before using needle visualization.Furthermore,according to the thyroid imaging reporting and data system proposed by the American College of Radiology,we graded the risk of the nodules.Lasso-Logistic regression was employed to screen out the factors influencing the performance of needle visualization and establish a nomogram for prediction. Results The needle tips were not clearly displayed in the examination of 135 (67.8%) and 53 (26.6%) nodules before and after the application of needle visualization,respectively,which showed a significant difference (P<0.001).Based on the positional relationship between the nodule and capsule,anteroposterior/transverse diameter (A/T) ratio,blood supply,and the distribution of subcutaneous strip structure at the puncture site,a nomogram was established to predict the probability of unclear display of the needle tips after application of needle visualization.The C-index of the prediction model was 0.75 (95%CI=0.67-0.84) and the area under the receiver operating characteristic curve was 0.72.The calibration curve confirmed the appreciable reliability of the prediction model,with the C-index of 0.70 in internal validation. Conclusions Needle visualization can improve the display of the needle tip in ultrasound-guided FNA of thyroid nodules.The nomogram established based on ultrasound features such as the positional relationship between the nodule and capsule,A/T ratio,blood supply,and the distribution of subcutaneous strip structure at the puncture site can predict whether needle visualization is suitable for the examination of nodules.

Objective To investigate the influencing factors of Bethesda Ⅲ results in fine-needle aspiration biopsy of thyroid nodules.Methods A total of 300 thyroid nodules with cytological diagnosis results were analyzed retrospectively,including 100 Bethesda Ⅲ nodules and 50 nodules of Bethesda Ⅱ,Ⅳ,Ⅴ,and Ⅵ categories,respectively.Univariate analysis and Logistic regression analysis were performed on the clinical data of patients and the ultrasound signs of thyroid nodules to clarify the factors influencing the diagnosis of Bethesda Ⅲ nodules.Results Univariate analysis showed that Bethesda Ⅲ nodules were mostly adjacent to the capsule(P<0.001),with no blood flow in the color Doppler assessment(P=0.011)and lack of blood supply(P=0.033)and maximum diameter ≤0.9 cm(P=0.038)as revealed by the contrast-enhanced ultrasound.Logistic regression showed that the position close to the capsule(OR=5.110,95%CI=2.153-12.130,P<0.001)and color Doppler without blood flow signal(OR=3.015,95%CI=1.094-8.311,P=0.033)were independent risk factors for the diagnosis of Bethesda Ⅲ nodules.Conclusions The puncture difficulty caused by the dangerous position of thyroid nodules close to the capsule and the aspiration difficulty caused by the absence of blood flow signal in color Doppler are the main factors influencing the diagnosis of Bethesda Ⅲ nodules.Therefore,corresponding avoidance measures should be taken during the aspiration process to reduce the diagnosis results of Bethesda Ⅲ nodules.

Objective To evaluate extrathyroidal extension (ETE) in papillary thyroid microcarcinoma (PTMC) with three-dimensional tomographic ultrasound imaging (3D-TUI). Methods A total of 97 thyroid nodules of 79 patients with PTMC treated in PUMC Hospital from February 2016 to January 2018 were included in this study.Two ultrasound experts performed independent blinded assessment of the relationship between thyroid nodules and thyroid capsule by two-dimensional ultrasound (2D-US) and 3D-TUI.The results of 2D-US and 3D-TUI in evaluating ETE were compared with intraoperative findings and postoperative histological and pathological results. Results Among the 97 nodules,54 (55.7%) nodules had ETE.The diagnostic sensitivity (68.5% vs.37.0%;χ2=10.737,P=0.002),accuracy (74.5% vs.56.7%;χ2=6.686,P=0.015),and area under the receiver operating characteristic curve[0.761 (95%CI=0.677-0.845) vs.0.592 (95%CI=0.504-0.680);Z=3.500,P<0.001] of 3D-TUI were higher than those of 2D-US.However,3D-TUI and 2D-US showed no significant difference in the specificity (84.1% vs.81.4%;χ2=0.081,P=0.776),negative predictive value (67.9% vs.50.7%;χ2=3.645,P=0.066),or positive predictive value (84.1% vs.71.4%;χ2=1.663,P=0.240). Conclusion Compared with 2D-US,3D-TUI demonstrates increased diagnostic efficiency for ETE of PTMC.

Objective To establish a nomogram for predicting the risk of cervical lymph node metastasis in differentiated thyroid carcinoma (DTC). Methods The patients with complete clinical data of DTC and cervical lymph node ultrasound and diagnosed based on pathological evidence from January 2019 to December 2021 were assigned into a training group (n=444) and a validation group (n=125).Lasso regression was performed to screen the data with differences between groups,and multivariate Logistic regression to establish a prediction model with the factors screened out by Lasso regression.C-index and calibration chart were employed to evaluate the prediction performance of the established model. Results The predictive factors for establishing the model were lymph node short diameter≥0.5 cm,long-to-short-axis ratio<2,disappearance of lymph node hilum,cystic transformation,hyperechogenicity,calcification,and abnormal blood flow (all P<0.001).The established model demonstrated a good discriminative ability,with the C index of 0.938 (95%CI=0.926-0.961) in the training group. Conclusion The nomogram established based on the ultrasound image features of cervical lymph nodes in DTC can accurately predict the risk of cervical lymph node metastasis in DTC.

The standardized training of residents in the Department of Ultrasound Medicine plays a key role in the continuing education of medical students and specialists after graduation. In recent years, as graduate students, the students who have just graduated and also social people are included in the standardized training of residents in the Department of Ultrasound Medicine, they have encountered some problems, such as uneven quality of trainees, lack of individualization of training Objectives, insufficient methodology for implementation and management, etc. This paper discusses the specific contents of the construction of standardized training system in the Department of Ultrasound Medicine, including cultural construction, curriculum construction, process assessment, and faculty development and so on. We can create our own characteristics in the standardized training of residents in the Department of Ultrasound Medicine through measures such as integrating curriculum and other resources, optimizing the application, perfecting and strictly implementing the training and assessment system, paying more attention to the capacity building of teachers, good working environment in the department and humanistic care, so as to lay the foundation and provide experience for the construction of a standardized training management system for ultrasound doctors in the future.