Preoperative Malignancy Risk Stratification in Bethesda IV Thyroid Nodules Using Integrated Clinical, Ultrasonographic, and Biochemical Parameters in Surgical Oncology Practice

Background and Objectives: Bethesda Category IV thyroid nodules present a diagnostic challenge due to their variable risk of malignancy and uncertain cytological features. Therefore, determining the risk of malignancy before surgery is important. This study aims to identify clinical, biochemical, and ultrasonographic factors associated with malignancy and to explore the performance of a multivariable analysis based on routinely available preoperative features in thyroid nodules.