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. 2024 Jul 10:17:3015-3025.
doi: 10.2147/IJGM.S456820. eCollection 2024.

Modified TI-RADS Coupled with BRAFV600E Enhances Diagnostic Efficiency in Papillary Thyroid Carcinoma: Prospective Study

Jing Wang  1 , Hong Cheng  1 , Xu Li  1
Affiliations

Modified TI-RADS Coupled with BRAFV600E Enhances Diagnostic Efficiency in Papillary Thyroid Carcinoma: Prospective Study

Jing Wang et al. Int J Gen Med. .

Abstract

Background: Thyroid disorders, relatively common diseases of the endocrine system, have risen gradually in recent years. Early detection and accurate diagnosis of thyroid cancer hold exceptional importance. This study aimed to determine the efficacy of a modified TI-RADS and BRAFV600E mutation testing for thyroid cancer (PTC) diagnosis.

Methods: Ninety five thyroid nodules (48 benign and 47 malignant) from 81 patients were examined using Kwak Thyroid Imaging Reporting and Data System (TI-RADS) were subjected to shear wave elasticity (SWE), BRAFV600E genotyping and fine needle aspiration (FNA) cytology.

Results: The modified TI-RADS exhibited superior diagnostic accuracy compared to TI-RADS in differentiating benign nodules from malignant thyroid nodules. Moreover, the AUC of modified TI-RADS in conjunction with BRAFV600E was the highest at 95% CI (0.898-0.992, p=0.003), surpassing other diagnostic methods in enhanced sensitivity and maintaining high specificity.

Conclusion: The diagnostic efficiency of this combination surpassed that of individual diagnostic methods.

Keywords: BRAFV600E; modified TI-RADS; papillary thyroid cancer; shear wave elasticity; stiff rim sign.

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Conflict of interest statement

The authors of this manuscript declare no relationships with any companies, whose products or services may be related to the subject matter of the article.

Figures

Figure 1
Figure 1
Diagram of the selection of patients with thyroid nodules.
Figure 2
Figure 2
The stiff rim (arrow) is a ring light banded area where the edge of the nodule is harder than the surrounding normal thyroid glands.
Figure 3
Figure 3
A representative image of a 49-year-old woman with benign FNA results and wild-type BRAF V600E. (a) CUS image showed hypoechogenicity, microcalcification, and solid component features in the longitudinal plane. (b) The nodule did not have a stiff rim. (c) SWE max and SWE ratio are shown on the elastic image as 20.4 KPa and 1.0kPa, respectively. Arrows denote nodule size and location. Color Doppler imaging distinguishes red blood flowing towards the transducer from blue blood receding.
Figure 4
Figure 4
A representative image of a 52-year-old woman with mutation type BRAF V600E and the pathological result PTC. (a) The CUS image showed hypoechogenicity, an irregular boundary, and microcalcification features in the longitudinal plane. (b) The nodule had a stiff rim. (c) SWE max and SWE ratio are shown on the elastic image with values of 65.5 kPa and 1.6 kPa, respectively. Arrows denote nodule size and location. Color Doppler imaging distinguishes red blood flowing towards the transducer from blue blood receding.
Figure 5
Figure 5
The receiver operating characteristic curves of shear-wave elastic parameters for the prediction of PTC.
Figure 6
Figure 6
The receiver operating characteristic curves of different test techniques for the prediction of PTC.
See this image and copyright information in PMC

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