From January 2018 to August 2020, 1782 consecutive patients with 2417 thyroid nodules who underwent high-resolution US examination and US-guided FNAB or surgery afterward at the Second Affiliated Hospital and Yuying Children’s Hospital of Wenzhou Medical University were involved in this study. The inclusion criteria were as follows: (I) preoperative or pre-FNAB US examinations with US reports were performed, and the images were saved as JPEG files; (II) the target nodules had undergone initial surgical resection or US-guided FNAB within 2 weeks of US examination; (III) surgery or FNAB was carried out within 2 weeks of US examination. The exclusion criteria were as follows: (I) the target nodules lacked a final pathological diagnosis after surgical resection; (II) cytopathological diagnosis of atypia or follicular lesion of undetermined significance and suspicion of malignancy by US-guided FNAB. Finally, 108 nodules were excluded due to a lack of US characteristics (n=37), lack of final pathological diagnosis after surgical resection (n=51), cytopathological diagnosis of atypia or follicular lesion of undetermined significance (n=16), and suspicion of malignancy (n=4) after FNAB. A total of 2,309 thyroid nodules in 1,697 patients were included in this study, including nodules that were diagnosed as benign or malignant on the basis of surgery (n=1,933), and those with initial definitive benign or malignant results at US-guided FNAB (n=376; Figure 1).

Flowchart showing the study participants. US, ultrasound; FNAB, fine-needle aspiration biopsy.

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