“Double-Flash”: An Innovative Method to Diagnose Papillary Thyroid Microcarcinomas

The aim of the study was to investigate the diagnostic ability of an innovative method called Double-Flash during contrast-enhanced ultrasound (CEUS) examination in papillary thyroid microcarcinomas. A total of 43 nodules measuring <10 mm and with definite pathology confirmed by surgery or fine-needle aspiration biopsy (FNAB) were included in this study. The bottom of Flash was pressed in the 40th and 60th seconds, respectively, defined as Double-Flash. The curve of reperfusion was evaluated and the diagnostic value of Double-Flash was compared with that of CEUS. Pathologic results obtained by surgery or FNAB revealed there were 27 malignant and 16 benign nodules. The sensitivity, specificity and accuracy of CEUS were 70.0%, 53.8% and 65.1%. With Double-Flash, the sensitivity, specificity and accuracy were 92.3%, 82.3% and 88.4%, respectively. The difference was statistically significant. Higher diagnostic ability is obtained with Double-Flash. The parameter based on the new method could improve the diagnostic performance of quantitative diagnosis in CEUS. The change in the perfusion curve after Flash may be a strong indicator of malignancy.