Fractal echoes with comet tails do not accurately determine benign or non-benign conditions, and further testing is required to analyze and determine this. A punctate echogenicity with comet tail is an ultrasound description of an organ on an image, which may be a gallbladder stone if present in the gallbladder or a calcified thyroid nodule if present in the thyroid gland. It is important to note, however, that no single ultrasound feature is unique to either benign or malignant nodules, and a combination of features must be analyzed in order to help differentiate between benign and malignant nodules. For example, a nodule with abundant, disorganized blood flow in the interior of the nodule and no blood flow in the periphery may be malignant. Therefore, punctate echoes with comet’s tail can only help the doctor to determine the condition, but cannot confirm the diagnosis. To determine whether the nodule is benign or not, it is necessary to combine its size, surrounding blood flow signal and biopsy to accurately determine.