Differentiating medullary thyroid carcinoma from papillary thyroid carcinoma using ultrasound viscosity imaging: a preliminary study

BACKGROUND: To investigate the clinical feasibility of ultrasound viscosity imaging in the differential diagnosis of medullary thyroid carcinoma (MTC), aiming to provide more precise diagnostic tools and to support optimized treatment decisions and personalized clinical management in clinical practice. METHODS: The study included patients diagnosed with MTC and PTC (papillary thyroid carcinoma) at Shanghai Ruijin Hospital between March 2024 and December 2024. Quantitative analysis was performed for ultrasound viscosity imaging of thyroid carcinoma. Statistically significant indicators were screened and their diagnostic performance was evaluated. RESULTS: A total of 35 MTC patients with 35 MTC nodules and 45 PTC patients with 45 PTC nodules were finally enrolled. Various ultrasound viscosity imaging features demonstrated statistically significant value for differentiating MTC. Among them, S1-Vsd (viscosity standard deviation under the Visco mode with Shell = 1.0 mm) exhibited the best diagnostic performance with an AUC (area under the curve) of 0.70, which is superior to conventional ultrasound ACR-TIRADS (AUC = 0.63). CONCLUSION: Ultrasound viscosity imaging shows promising potential in enhancing the diagnostic accuracy of thyroid carcinoma, providing valuable support in differentiating MTC from PTC.