Objective:

To develop an optimal DECT radiomics model for evaluating the nature of thyroid nodules and to explore the clinical significance of combining quantitative parameters with radiomics features in DECT imaging for preoperative prediction of benign and malignant thyroid nodules, emphasizing the potential impact on treatment decisions.

Key Findings:

• DECT quantitative assessment shows higher accuracy than conventional CT in differentiating thyroid nodules.
• Material decomposition images and radiomics features significantly enhance the differentiation between benign and malignant nodules.
• The study indicates a potential for improved preoperative prediction of thyroid nodule nature using DECT, which may influence clinical decision-making.

Interpretation:

The combination of quantitative metrics and radiomics from DECT imaging can significantly improve diagnostic accuracy for differentiating between benign and malignant thyroid nodules, potentially guiding treatment decisions more effectively by providing clearer insights into nodule characteristics.

Limitations:

• Retrospective design may introduce selection bias, affecting the generalizability of results.
• Limited generalizability due to single-center study, which may not reflect broader patient populations.
• Potential variability in imaging techniques and interpretation could impact the consistency of findings.

Conclusion:

The study supports the use of DECT imaging combined with radiomics for enhanced preoperative evaluation of thyroid nodules, which may lead to better patient management and tailored treatment strategies.