Jin ZQ, et al. - Using gray-scale ultrasound, contrast-enhanced ultrasound (CEUS) and shear-wave elastography (SWE) images, researchers created a modified Thyroid Imaging Reporting and Data System (TI-RADS) score to predict thyroid nodules malignancy and compared this modified score system with the scoring criteria based on the Thyroid Imaging Reporting and Data System (TI-RADS, 2017 edition). The outcomes showed that the malignancy rate for TI-RADS category 4 and 5 nodules increased from 47.6% with American College of Radiology (ACR) TI-RADS evaluation alone to 49.4% with ACR TI-RADS combined with shear wave elastography (SWE) and CEUS (enhanced pattern) by using SWE and CEUS (enhanced pattern) to downgrade TI-RADS category 4 and 5 nodules. Findings suggested that the modified TI-RADS based on ACR TI-RADS + SWE + CEUS (enhanced pattern) could lower the number of biopsies performed on benign nodules and help implement consistent follow-up in clinical practice.