Thyroglobulin-to-tumor volume ratio combined with ultrasound features for diagnosing thyroid follicular neoplasms

ObjectiveCurrent preoperative diagnostics inadequately differentiate benign from malignant thyroid follicular neoplasms. This study evaluated the diagnostic utility of thyroid function markers and contrast-enhanced ultrasound (CEUS) features in differentiating follicular thyroid adenoma (FTA) from f...

Full description

Saved in:
Bibliographic Details
Main Authors: Xixi Zhu, Fen Liu, Jiaye Liu, Zhihui Li, Yu Ma
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-07-01
Series:Frontiers in Endocrinology
Subjects:
Online Access:https://www.frontiersin.org/articles/10.3389/fendo.2025.1626766/full
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1849415126857285632
author Xixi Zhu
Xixi Zhu
Fen Liu
Jiaye Liu
Jiaye Liu
Zhihui Li
Yu Ma
author_facet Xixi Zhu
Xixi Zhu
Fen Liu
Jiaye Liu
Jiaye Liu
Zhihui Li
Yu Ma
author_sort Xixi Zhu
collection DOAJ
description ObjectiveCurrent preoperative diagnostics inadequately differentiate benign from malignant thyroid follicular neoplasms. This study evaluated the diagnostic utility of thyroid function markers and contrast-enhanced ultrasound (CEUS) features in differentiating follicular thyroid adenoma (FTA) from follicular thyroid carcinoma (FTC), focusing on a novel parameter: the thyroglobulin-to-tumor volume ratio (Tg/Vol ratio).MethodsWe retrospectively analyzed 432 resected thyroid follicular neoplasms. A comprehensive comparison was performed regarding baseline characteristics, thyroid function profiles, and CEUS features between FTA and FTC groups through univariate and multivariate binary logistic regression. Diagnostic performance was determined via receiver operating characteristic (ROC) curve analysis. The prevalence of FTC across serum marker subgroups was assessed, followed by the development of a multivariate diagnostic model integrating the Tg/Vol ratio with CEUS characteristics.ResultsAmong 432 patients (352 females, 81.5%) with a median age of 47 years, multivariate logistic regression analysis revealed three independent predictors of FTC: capsular involvement (odds ratio [OR] = 9.958, 95% confidence interval [CI]: 2.453 – 40.424, p = 0.001), Tg/Vol ratio >7.412 (OR = 3.508, 95% CI: 1.388 – 8.868, p = 0.008), and male gender (OR = 3.474, CI: 1.751 – 6.891, p < 0.001). Subgroup analyses revealed higher FTC prevalence in patients with Tg > 409.18 μg/L (20.41%, p = 0.002) and Tg/Vol ratio > 20.68 (20.41%, p = 0.009). The combined diagnostic model incorporating Tg/Vol ratio and CEUS features demonstrated 69.4% sensitivity, 77.0% specificity, and the area under the curve(AUC) of 0.769.ConclusionWhile elevated preoperative Tg correlates with malignant potential, but the Tg/Vol ratio emerges as a more robust preoperative discriminator. The combined diagnostic model incorporating Tg/Vol ratio and CEUS features significantly improves FTC detection accuracy.
format Article
id doaj-art-078bf70fcfc048c3aaecc85d79e58b4f
institution Kabale University
issn 1664-2392
language English
publishDate 2025-07-01
publisher Frontiers Media S.A.
record_format Article
series Frontiers in Endocrinology
spelling doaj-art-078bf70fcfc048c3aaecc85d79e58b4f2025-08-20T03:33:37ZengFrontiers Media S.A.Frontiers in Endocrinology1664-23922025-07-011610.3389/fendo.2025.16267661626766Thyroglobulin-to-tumor volume ratio combined with ultrasound features for diagnosing thyroid follicular neoplasmsXixi Zhu0Xixi Zhu1Fen Liu2Jiaye Liu3Jiaye Liu4Zhihui Li5Yu Ma6Division of Thyroid Surgery, Department of General Surgery; Laboratory of Thyroid and Parathyroid Diseases, Frontiers Science Center for Disease-Related Molecular Network, West China Hospital, Sichuan University, Chengdu, ChinaDepartment of Respiratory and Critical Care Medicine, Frontiers Science Center for Disease-related Molecular Network, Center of Precision Medicine, Precision Medicine Key Laboratory of Sichuan Province, West China Hospital, Sichuan University, Chengdu, Sichuan, ChinaDepartment of Operating Room, West China Hospital, West China School of Nursing, Sichuan University, Chengdu, Sichuan, ChinaDivision of Thyroid Surgery, Department of General Surgery; Laboratory of Thyroid and Parathyroid Diseases, Frontiers Science Center for Disease-Related Molecular Network, West China Hospital, Sichuan University, Chengdu, ChinaDepartment of Respiratory and Critical Care Medicine, Frontiers Science Center for Disease-related Molecular Network, Center of Precision Medicine, Precision Medicine Key Laboratory of Sichuan Province, West China Hospital, Sichuan University, Chengdu, Sichuan, ChinaDivision of Thyroid Surgery, Department of General Surgery; Laboratory of Thyroid and Parathyroid Diseases, Frontiers Science Center for Disease-Related Molecular Network, West China Hospital, Sichuan University, Chengdu, ChinaDivision of Thyroid Surgery, Department of General Surgery; Laboratory of Thyroid and Parathyroid Diseases, Frontiers Science Center for Disease-Related Molecular Network, West China Hospital, Sichuan University, Chengdu, ChinaObjectiveCurrent preoperative diagnostics inadequately differentiate benign from malignant thyroid follicular neoplasms. This study evaluated the diagnostic utility of thyroid function markers and contrast-enhanced ultrasound (CEUS) features in differentiating follicular thyroid adenoma (FTA) from follicular thyroid carcinoma (FTC), focusing on a novel parameter: the thyroglobulin-to-tumor volume ratio (Tg/Vol ratio).MethodsWe retrospectively analyzed 432 resected thyroid follicular neoplasms. A comprehensive comparison was performed regarding baseline characteristics, thyroid function profiles, and CEUS features between FTA and FTC groups through univariate and multivariate binary logistic regression. Diagnostic performance was determined via receiver operating characteristic (ROC) curve analysis. The prevalence of FTC across serum marker subgroups was assessed, followed by the development of a multivariate diagnostic model integrating the Tg/Vol ratio with CEUS characteristics.ResultsAmong 432 patients (352 females, 81.5%) with a median age of 47 years, multivariate logistic regression analysis revealed three independent predictors of FTC: capsular involvement (odds ratio [OR] = 9.958, 95% confidence interval [CI]: 2.453 – 40.424, p = 0.001), Tg/Vol ratio >7.412 (OR = 3.508, 95% CI: 1.388 – 8.868, p = 0.008), and male gender (OR = 3.474, CI: 1.751 – 6.891, p < 0.001). Subgroup analyses revealed higher FTC prevalence in patients with Tg > 409.18 μg/L (20.41%, p = 0.002) and Tg/Vol ratio > 20.68 (20.41%, p = 0.009). The combined diagnostic model incorporating Tg/Vol ratio and CEUS features demonstrated 69.4% sensitivity, 77.0% specificity, and the area under the curve(AUC) of 0.769.ConclusionWhile elevated preoperative Tg correlates with malignant potential, but the Tg/Vol ratio emerges as a more robust preoperative discriminator. The combined diagnostic model incorporating Tg/Vol ratio and CEUS features significantly improves FTC detection accuracy.https://www.frontiersin.org/articles/10.3389/fendo.2025.1626766/fullthyroid follicular neoplasmfollicular thyroid carcinomathe serum thyroglobulin-to-tumor volume ratiothyroglobulinultrasonography
spellingShingle Xixi Zhu
Xixi Zhu
Fen Liu
Jiaye Liu
Jiaye Liu
Zhihui Li
Yu Ma
Thyroglobulin-to-tumor volume ratio combined with ultrasound features for diagnosing thyroid follicular neoplasms
Frontiers in Endocrinology
thyroid follicular neoplasm
follicular thyroid carcinoma
the serum thyroglobulin-to-tumor volume ratio
thyroglobulin
ultrasonography
title Thyroglobulin-to-tumor volume ratio combined with ultrasound features for diagnosing thyroid follicular neoplasms
title_full Thyroglobulin-to-tumor volume ratio combined with ultrasound features for diagnosing thyroid follicular neoplasms
title_fullStr Thyroglobulin-to-tumor volume ratio combined with ultrasound features for diagnosing thyroid follicular neoplasms
title_full_unstemmed Thyroglobulin-to-tumor volume ratio combined with ultrasound features for diagnosing thyroid follicular neoplasms
title_short Thyroglobulin-to-tumor volume ratio combined with ultrasound features for diagnosing thyroid follicular neoplasms
title_sort thyroglobulin to tumor volume ratio combined with ultrasound features for diagnosing thyroid follicular neoplasms
topic thyroid follicular neoplasm
follicular thyroid carcinoma
the serum thyroglobulin-to-tumor volume ratio
thyroglobulin
ultrasonography
url https://www.frontiersin.org/articles/10.3389/fendo.2025.1626766/full
work_keys_str_mv AT xixizhu thyroglobulintotumorvolumeratiocombinedwithultrasoundfeaturesfordiagnosingthyroidfollicularneoplasms
AT xixizhu thyroglobulintotumorvolumeratiocombinedwithultrasoundfeaturesfordiagnosingthyroidfollicularneoplasms
AT fenliu thyroglobulintotumorvolumeratiocombinedwithultrasoundfeaturesfordiagnosingthyroidfollicularneoplasms
AT jiayeliu thyroglobulintotumorvolumeratiocombinedwithultrasoundfeaturesfordiagnosingthyroidfollicularneoplasms
AT jiayeliu thyroglobulintotumorvolumeratiocombinedwithultrasoundfeaturesfordiagnosingthyroidfollicularneoplasms
AT zhihuili thyroglobulintotumorvolumeratiocombinedwithultrasoundfeaturesfordiagnosingthyroidfollicularneoplasms
AT yuma thyroglobulintotumorvolumeratiocombinedwithultrasoundfeaturesfordiagnosingthyroidfollicularneoplasms