Multimodal Ultrasound Integration Pathways and Paradigm Innovations in Precision Diagnosis and Treatment of Thyroid Cancer.

Thyroid cancer, the fastest-growing endocrine malignancy, is shifting from morphological evaluation to molecular-functional imaging. This review systematically evaluates the translational value of multimodal ultrasound technologies-high-frequency ultrasound (HFUS), elastography, contrast-enhanced ultrasound (CEUS), and super-resolution imaging (SRI)-across the entire "screening-diagnosis-treatment-follow-up" continuum of thyroid cancer management. A systematic literature synthesis was performed, aggregating data from clinical studies and preclinical trials that assessed multimodal ultrasound technologies in thyroid cancer. Key quantitative parameters extracted for analysis included: microcalcification detection rate using HFUS with artificial intelligence (AI), diagnostic specificity based on elastography (Emax cutoff) combined with molecular biomarkers (VEGF, PD-L1), spatial resolution and microvascular metrics (microvessel density [MVD], microvascular flow rate [MFR]) achieved by SRI, and complete ablation rate of ultrasound-guided ablation coupled with targeted microbubble technology. Emerging evidence on ultrasound radiomics and genomics was also reviewed. Morpho-functional dual-modal assessment using 10-24 MHz HFUS probes integrated with AI achieved a 91.4% detection rate for microcalcifications (<1 mm). Quantitative elastography parameters (Emax ≥30.65 kPa) combined with molecular imaging biomarkers (VEGF, PD-L1) elevated diagnostic specificity to 93.6%. SRI broke the 50 µm resolution barrier, enabling three-dimensional microvascular topology reconstruction and quantification of MVD and MFR. Ultrasound-guided ablation together with targeted microbubble technology attained a 92.3% complete ablation rate for microcarcinomas. The review further identified frontier integration of ultrasound radiomics and genomics as multidimensional evidence for precision management. Multimodal ultrasound technologies (HFUS, elastography, CEUS, SRI) provide robust translational value across the thyroid cancer care continuum, significantly improving detection, diagnostic specificity, microvascular imaging, and therapeutic efficacy, thereby supporting precision thyroid cancer management.