Diagnostic value of contrast-enhanced ultrasound combined with BRAF V600E mutation for cytologically indeterminate thyroid nodules

Abstract

Objective To evaluate the diagnostic efficacies of contrast-enhanced ultrasound(CEUS) combined with BRAF V600E mutation detection in ultrasound-guided fine-needle aspiration cytology of thyroid nodules with atypia of undetermined significance. Methods A total of 129 thyroid nodules underwent the examinations of CEUS and BRAF V600E mutation were analyzed retrospectively. With surgical pathology as the gold standard, ROC curve was used to investigate the diagnostic values of CEUS, BRAF V600E and the combination of the two methods. Results The sensitivity, specificity and accuracy of CEUS and BRAF V600E gene detection for thyroid nodules with atypia of undetermined significance diagnosed by ultrasound-guided fine-needle aspiration biopsy were 86.7%, 83.3%, 85.3% and 72.0%, 100%, 83.7%, respectively. The sensitivity and accuracy of CEUS were higher than those of BRAF V600E gene detection (all P<0.001), however its specificity was lower than BRAF V600E with statistically significance(P<0.001), those of the combined test of CEUS and BRAF V600E mutation analysis were 94.7%, 83.3%, 89.9%, respectively. The combination of two methods had the highest diagnostic efficacy, with statistically difference (P<0.001), and the area under the ROC curve (AUC) was higher than that for each test(0.951 vs 0.860 vs 0.901). Conclusions The combined test of CEUS and BRAF V600E mutation has a higher diagnostic efficacy for cytologically indeterminate thyroid nodules compared with CEUS or BRAF V600E mutation alone. Key words: Contrast-enhanced ultrasound; Thyroid nodule; BRAF V600E gene; Mutation; Fine needle aspiration biopsy