Performance of contrast-enhanced ultrasound in thyroid nodules: Review of current state and future perspectives

Maija Radzina (Coresponding Author), Madara Ratniece, Davis Simanis Putrins, Laura Saule, Vito Cantisani

Research output: Contribution to journalReview articlepeer-review

44 Citations (Scopus)
4 Downloads (Pure)


Ultrasound has been established as a baseline imaging technique for thyroid nodules. The main advantage of adding CEUS is the ability to assess the sequence and intensity of vascular perfusion and hemodynamics in the thyroid nodule, thus providing real-time characterization of nodule features, considered a valuable new approach in the determination of benign vs. malignant nod-ules. Original studies, reviews and six meta-analyses were included in this article. A total of 624 studies were retrieved, and 107 were included in the study. As recognized for thyroid nodule malignancy risk stratification by US, for acceptable accuracy in malignancy a combination of several CEUS parameters should be applied: hypo-enhancement, heterogeneous, peripheral irregular enhancement in combination with internal enhancement patterns, and slow wash-in and wash-out curve lower than in normal thyroid tissue. In contrast, homogeneous, intense enhancement with smooth rim enhancement and “fast-in and slow-out” are indicative of the benignity of the thyroid nodule. Even though overlapping features require standardization, with further research, CEUS may achieve reliable performance in detecting or excluding thyroid cancer. It can also play an op-erative role in guiding ablation procedures of benign and malignant thyroid nodules and metastatic lymph nodes, and providing accurate follow-up imaging to assess treatment efficacy.

Original languageEnglish
Article number5469
Number of pages19
Issue number21
Publication statusPublished - 30 Oct 2021


  • Contrast-enhanced ultrasound (CEUS)
  • Follicular thyroid cancer
  • Papillary thyroid cancer
  • Thyroid cancer
  • Thyroid nodules

Field of Science*

  • 3.2 Clinical medicine
  • 3.1 Basic medicine

Publication Type*

  • 1.1. Scientific article indexed in Web of Science and/or Scopus database


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