Khadra H, et al. - Whether suspicious ultrasound (US) features can predict the more aggressive papillary thyroid carcinoma (PTC) associated with B-type Raf kinase (BRAFV600E) mutation was investigated in this analysis. The study findings suggested that the occurrence of multiple suspicious US findings of thyroid nodules can forecast the BRAFV600E mutation status of papillary thyroid cancer nodules. By combining calcification, irregular margins, and hypoechogenicity with extrathyroidal extension and lymph node (LN) metastasis, the highest accuracy overall (93.2%) was achieved.

Methods

• For this retrospective review, researchers prospectively gathered data on patients with PTC and known BRAFV600E status.
• All enrolled patients had preoperative US by the same surgeon who performed all the operations.
• Patients were divided into BRAFV600E positive and negative groups.
• Finally, all ultrasonographic data were gathered, including nodule size, echogenicity, solid or cystic nature, presence of calcifications, irregular margins, and internal vascularity.

Results

• According to the findings obtained, out 141 patients with PTC, BRAFV600E mutation was identified in 48 (34.0%) patients.
• No significant difference was found in nodule size (2.06 cm ± 1.37 vs. 2.15 cm ±1.55, p=0.75) between BRAFV600E positive and negative groups.
• Findings revealed that BRAFV600E positivity was associated with higher rates of ­hypoechogenicity (57.5% vs 36.6, p=0.02), calcifications (48.9 vs. 19.4%, p < 0.01), and irregular margins (21.3 vs. 6.5%, p < 0.01).
• No significant difference was found in the noncystic nature or internal vascularity between BRAFV600E positive and negative groups.
• Data reported that the presence of all suspicious US features was correlated with a positive predictive value of 100%.
• The negative predictive value was 84.2% in the absence of all suspicious features.
• No significant difference was found between BRAFV600E positive and negative groups (30.6 vs. 21.7%, p=0.35) when suspicious lymph nodes (LNs) detected by preoperative US were compared.