Comprehensive linkage between molecular biology and imaging radiomics for thyroid nodules

Thyroid nodules are common, with a prevalence of approximately 70% on thyroid ultrasonography; approximately 5% of these nodules are malignant. Distinguishing malignant and benign thyroid nodules is critical for clinical management. Clinicians can judiciously select patients for fine-needle aspiration, understand the cytology results and subsequent follow-up, and determine surveillance strategies for non-operated nodules. The challenge in selecting thyroid nodules for fine-needle aspiration is to avoid the diagnosis of small, clinically insignificant cancers without missing more severe diseases. The molecular characteristics of thyroid nodules are critical for their diagnosis and treatment. However, identifying these characteristics is costly and challenging because of unexpected technical difficulties. An imaging association model based on molecular features will bridge the essential link between molecular characteristics and the computed tomography radiomics, then improve diagnostic efficiency, reducing invasive examinations.