Establish a Nomogram Based on Ultrasound Novel Vascularity Characteristics to Differentiate Follicular Thyroid Carcinoma From Follicular Benign Neoplasms.

Purpose: This study aimed to construct a nomogram based on novel ultrasound vascularity features to differentiate follicular thyroid carcinoma (FTC) from follicular benign neoplasms (FBN).

Methods: A total of 153 patients were included. We evaluated various sonographic features of all nodules and analyzed the diagnostic efficiency of different vascularity patterns for FTC. Furthermore, independent predictors for FTC were screened using multivariable logistic regression. A nomogram was established to predict FTC, and various methods were used to evaluate the performance of the nomogram.

Results: The firework-like pattern and central-grasp pattern were more likely to appear in the FTC (p < 0.001, p = 0.007), while the ring-like pattern was more likely to appear in the FBN (p < 0.001). The firework-like pattern showed the best performance in accuracy (71.2%) and NPV (73.4%) among other vascularity patterns. Besides, thick hypo-halo, ring-like pattern, central-grasp pattern, and firework-like pattern were four predictors used to construct the nomogram. The bootstrap AUC was 0.814 (95% CI: 0.743-0.884) which revealed the nomogram had accurate prediction accuracy.

Conclusion: The firework-like pattern and central-grasp pattern were vascularity characteristics for FTC, while the ring-like pattern was for FBN. Besides, our nomogram based on novel vascularity characteristics can help distinguish FTC and FBN before operation.