Evaluation of the diagnostic performance of contrast-enhanced ultrasound combined with BRAF V600E gene detection in nodules of unclear significance by thyroid fine-needle aspiration.

Abstract

Our study aims to test the diagnostic performance of contrast-enhanced ultrasound (CEUS) combined with the detection of serine/threonine-protein kinase V600E (BRAF V600E) in nodules of unclear significance by thyroid fine-needle aspiration (FNA). From January 2015 to December 2019, 244 patients were subjected to ultrasonic strain imaging and elastography, CEUS, and BRAF V600E gene detection at Lishui Hospital of Zhejiang University. Thyroid FNA does not confirm the benignancy and malignancy of the thyroid nodules. With postoperative pathology as the gold standard, the diagnostic value of CEUS, BRAF V600E detection, and the combination in differentiating benign and malignant thyroid nodules were evaluated. The negative predictive value (NPV) and accuracy of CEUS, BRAF V600E detection, and the combination were calculated along with sensitivity, specificity, and positive predictive value (PPV). In this study, the sensitivity, specificity, PPV, NPV, accuracy, and AUC of CEUS alone in predicting benign and malignant thyroid nodules were 69.8%, 94.9%, 98.6%, 37.4%, 73.8% and 0.884, respectively. The sensitivity, specificity, PPV, NPV, accuracy and AUC of BRAF V600E detection alone were 65.4%, 100%, 100%, 35.5%, 70.9% and 0.827, respectively. The sensitivity, specificity, PPV, NPV, accuracy and AUC of the combination were 73.2%, 94.9%, 98.7%, 40.2%, 76.6% and 0.923, respectively. Therefore, compared with CEUS or BRAF V600E gene detection alone, the combination of CEUS and BRAF V600E gene detection has a higher sensitivity, NPV, and accuracy in the diagnosis of thyroid nodules.