Papillary Thyroid Carcinoma (PTC) accounts for more than 80% of thyroid cancers, and cervical Central Lymph Node Metastasis (CLNM) is a critical risk factor affecting patient prognosis. Conventional ultrasound is the first-line method for preoperative evaluation of PTC, but it is restricted by operator subjectivity, image quality interference, and limited diagnostic accuracy for CLNM. Multimodal ultrasound radiomics and deep learning have emerged as innovative technical approaches to address these limitations. This paper reviews the research progress of multimodal ultrasound radiomics and deep learning in predicting CLNM in PTC, covering modality composition, feature extraction, multimodal fusion strategies, model efficacy, and clinical application value. Current studies confirm that multimodal ultrasound radiomics integrating B-mode, contrast-enhanced ultrasound, elastography and microflow imaging achieves an Area Under the Curve (AUC) of 0.78–0.97 for CLNM prediction, significantly outperforming single-modal ultrasound. Deep learning models based on convolutional neural networks and Transformer architectures realize end-to-end automatic prediction with high efficiency. However, most studies are retrospective single-center designs, resulting in insufficient model generalization; the "black box" problem of artificial intelligence and the shallow application of Explainable Artificial Intelligence (XAI) also restrict clinical translation. In conclusion, multimodal ultrasound radiomics and deep learning break through the bottlenecks of conventional ultrasound and provide reliable support for preoperative non-invasive risk assessment of PTC. Future research should focus on prospective multicenter trials, unified imaging standards, optimized XAI methods and multi-omics integration to promote clinical application.
Research Article
Open Access