A multimodal ultrasound approach: quantitative speed-of-sound, elastography, and B-mode imaging for predicting papillary thyroid carcinoma invasiveness

Background: Papillary thyroid carcinoma (PTC) is the most common malignant tumor of the thyroid gland, and its aggressiveness determines distinct therapeutic and management strategies. This study aimed to evaluate the diagnostic performance of quantitative speed-of-sound (QSOS), elastography, and B-mode imaging in assessing the aggressiveness of PTC. Methods: A total of 157 patients with solitary PTC were enrolled and classified into two groups based on pathological findings: an invasive group (n=118) and a non-invasive group (n=39). All patients underwent B-mode imaging, QSOS imaging, and elastography. Speed-of-sound (SOS)1, SOS2, and SOS3 represent the SOS measurements at different regions of the nodule, and the difference refers to the value of SOS1 minus SOS3. Results: . 11.6±11.9 m/s). Binary logistic regression analysis identified SOS2, maximum diameter, and the difference as independent predictors of PTC invasiveness. Their odds ratios (ORs) were 0.857, 1.274, and 0.945, respectively (all P