CEUS Improves Diagnosis of Benign TI-RADS 4-5 Thyroid Nodules in Matched Cohort

Adding contrast-enhanced ultrasound (CEUS) to conventional US improved AUC from 0.699 to 0.780 for differentiating benign from malignant TI-RADS 4-5 thyroid nodules in a retrospective, propensity-matched surgical cohort. Absence of filling defects was linked to malignancy.

• After matching, 81 benign and 81 malignant nodules were compared; absence of filling defects on CEUS was independently associated with malignancy (p < 0.05).
• The combined model AUC was 0.780 vs. 0.699 for conventional US alone.
• CEUS patterns varied by benign nodule subtype, reflecting different pathological bases.

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