scholarly journals Diagnostic Efficacy of Ultrasound, Cytology, and BRAFV600E Mutation Analysis and Their Combined Use in Thyroid Nodule Screening for Papillary Thyroid Microcarcinoma

2022 ◽  
Vol 11 ◽  
Author(s):  
Jing Du ◽  
Ruijun Han ◽  
Cui Chen ◽  
Xiaowei Ma ◽  
Yuling Shen ◽  
...  
Keyword(s):  
Mutation Analysis ◽  
Roc Curve ◽  
Thyroid Nodules ◽  
Papillary Thyroid Microcarcinoma ◽  
Maximum Diameter ◽  
Diagnostic Efficiency ◽  
Papillary Thyroid ◽  
Diagnostic Efficacy ◽  
Thyroid Microcarcinoma ◽  
Combined Use

BackgroundUltrasound, cytology, and BRAFV600E mutation analysis were applied as valuable tools in the differential diagnosis of thyroid nodules. The aim of the present study was to evaluate the diagnostic efficiency of the three methods and their combined use in screening for papillary thyroid microcarcinoma (PTMC).MethodsA total of 1,081 patients with 1,157 thyroid nodules (0.5–1 cm in maximum diameter) classified as thyroid imaging reporting and data system (TIRADS) 4–5 were recruited. All patients underwent ultrasound, fine-needle aspiration (FNA) examination, and an additional BRAFV600E mutation test. TIRADS and Bethesda System for Reporting Thyroid Cytopathology (BSRTC) were adopted to judge the ultrasound and cytological results. The receiver operating characteristic (ROC) curve was established to assess the diagnostic values of different methods.ResultsOf the 1,157 nodules, 587 were benign and 570 were PTMCs. BRAFV600E mutation test had highest sensitivity (85.4%), specificity (97.1%), accuracy (91.4%), and area under the ROC curve (Az) value (0.913) among the three methods. The combination of BSRTC and BRAFV600E mutation analysis yielded a considerably high sensitivity (96.0%), accuracy (94.3%), and negative predictive value (95.9%) than either BSRTC or BRAFV600E mutation alone (P < 0.0001 for all comparisons). Of all the methods, the combined use of the three methods produced the best diagnostic performance (Az = 0.967), which was significantly higher than that (Az = 0.943) for the combination of BSRTC and BRAFV600E mutation (P < 0.0001). The diagnostic accuracy of the molecular method in the 121 nodules with indeterminate cytology was 90.1% (109/121), which was significantly higher than that of TIRADS classification, 74.4% (90/121) (P = 0.002).ConclusionThe combined use of ultrasound, cytology, and BRAFV600E mutation analysis is the most efficient and objective method for diagnosing PTMC. Both BRAFV600E mutation and TIRADS classification are potentially useful adjuncts to differentiate thyroid nodules, especially indeterminate samples classified as BSRTC III.

Prevalence and Prediction for Malignancy of Additional Thyroid Nodules Coexisting with Proven Papillary Thyroid Microcarcinoma

2013 ◽  
Vol 149 (1) ◽  
pp. 53-59 ◽  
Author(s):  
Sung Yong Choi ◽  
Seung Hoon Woo ◽  
Jung Hee Shin ◽  
Noorie Choi ◽  
Young-Ik Son ◽  
...  
Keyword(s):  
Thyroid Nodules ◽  
Papillary Thyroid Microcarcinoma ◽  
Papillary Thyroid ◽  
Thyroid Microcarcinoma

Preoperative prediction of papillary thyroid microcarcinoma via multiparameter ultrasound

2017 ◽  
Vol 58 (11) ◽  
pp. 1303-1311 ◽  
Author(s):  
Hui Juan Ma ◽  
Jing Chun Yang ◽  
Zhen Peng Leng ◽  
Ying Chang ◽  
Hua Kang ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Roc Curve ◽  
Imaging Modality ◽  
Multivariate Logistic Regression Analysis ◽  
Strain Ratio ◽  
Papillary Thyroid Microcarcinoma ◽  
Papillary Thyroid ◽  
Roc Curve Analysis ◽  
Thyroid Microcarcinoma ◽  
Heterogeneous Enhancement

Background Accurate diagnosis of papillary thyroid microcarcinoma (PTMC) is important for further management. Ultrasound (US) is the most frequently used imaging modality for PTMC. Purpose To evaluate the diagnostic value of conventional US, contrast-enhanced ultrasound (CEUS) and real-time elastography (RTE) for patients with PTMC. Material and Methods In total, 135 patients with subcentimeter thyroid nodules who underwent conventional US, CEUS, and RTE before surgery were enrolled. A multivariate logistic regression analysis was performed to assess the independent predictors of PTMC. The diagnostic performances of conventional US, CEUS, and RTE were evaluated with a receiver operating characteristic (ROC) curve analysis. Results A taller-than-wide shape was identified as the strongest predictor of PTMC (odds ratio [OR], 25.21), followed by heterogeneous enhancement (OR, 24.03), marked hypoechogenicity (OR, 21.71), poorly defined margin (OR, 5.51), strain ratio (OR, 2.59), and age (OR, 0.92; all P values < 0.05). Heterogeneous enhancement on CEUS showed the highest positive predictive value (PPV; 88.0%) and an accuracy of 83.7%. A logistic regression model was created to predict PTMC using conventional US, CEUS, and RTE. The area under the ROC curve was 0.97, with a sensitivity of 88.6% and a specificity of 94.6%. Conclusion Conventional US combined with CEUS and RTE can improve the diagnostic accuracy of PTMC.

Comparison of ACR TI-RADS, Kwak TI-RADS, ATA guidelines and KTA/KSThR guidelines in combination with SWE in the diagnosis of thyroid nodules

2021 ◽  
pp. 1-12
Author(s):  
Wen-Fang Deng
Keyword(s):  
Roc Curve ◽  
High Performance ◽  
Thyroid Nodules ◽  
Shear Wave Elastography ◽  
Roc Curves ◽  
Classification Systems ◽  
Maximum Diameter ◽  
Youden Index ◽  
Diagnostic Efficacy ◽  
Ultrasound Classification

OBJECTIVE: To compare the diagnostic efficacy of ACR TI-RADS, Kwak TI-RADS, ATA guidelines and KTA/KSThR guidelines in combination with shear wave elastography (SWE) for thyroid nodules. METHODS: The retrospective study included 566 thyroid nodules with maximum diameter≥5 mm which confirmed by FNA cytology or/and surgical pathology. The sensitivity, specificity, accuracy, Youden index of diagnosis of thyroid nodules by ACR TI-RADS, Kwak TI-RADS, ATA guidelines, KTA/KSThR guidelines and SWE were calculated. The ROC curve was drawn to determine the cut-off values of the four ultrasound classification systems and SWE Emax. The diagnostic efficacy of the four ultrasound classification systems in combination with SWE were calculated and compared with those of pre-combination. RESULTS: The ROC curves indicated that the cut-off value of ACR TI-RADS, Kwak TI-RADS, ATA guidelines, KTA/KSThR guidelines and Emax of SWE was TR5, 4c, high-suspicion, high-suspicion, and 41.7 kPa, respectively, and the area under the ROC curve (AUC) was 0.907(0.879–0.934), 0904(0.876–0.932), 0.894(0.863–0.924), 0.888(0.856–0.919), 0.886(0.859–0.913), respectively. After combination with SWE, the the sensitivities of the four ultrasound classification systems for the diagnosis of nodules were improved, and the differences were statistically significant (all P≤0.001); the specificities were decreased, but the differences were not statistically significant (all P >  0.05); the accuracies were improved, but only the difference of ACR TI-RADS was statistically significant (x2 = 4.45, p = 0.035); the differences in the AUCs were not significant (all P >  0.05). CONCLUSIONS: The four ultrasound classification systems and SWE all had high performance in the diagnosis of thyroid nodules. The four classification systems in combination with SWE were all beneficial to the differential diagnosis of nodules, and ACR TI-RADS in combination with SWE was more effective, especially for TR3 and TR4 nodules.

scholarly journals Acoustic Radiation Force Impulse Imaging: A New Tool for the Diagnosis of Papillary Thyroid Microcarcinoma

2014 ◽  
Vol 2014 ◽  
pp. 1-10 ◽  
Author(s):  
Yi-Feng Zhang ◽  
Chang Liu ◽  
Hui-Xiong Xu ◽  
Jun-Mei Xu ◽  
Jing Zhang ◽  
...  
Keyword(s):  
Risk Factors ◽  
Diagnostic Performance ◽  
Thyroid Nodules ◽  
Acoustic Radiation Force Impulse ◽  
Papillary Thyroid Microcarcinoma ◽  
Papillary Thyroid ◽  
Thyroid Microcarcinoma ◽  
Arfi Elastography ◽  
Independent Risk Factors ◽  
Arfi Imaging

Purpose. To evaluate the diagnostic performance of ARFI imaging in differentiating between benign and malignant thyroid nodules <1 cm.Materials and Methods. 173 pathologically proven thyroid nodules (77 benign, 96 malignant) in 157 patients were included in this study. Receiver-operating characteristic curve (ROC) analyses were performed to assess the diagnostic performance of conventional ultrasound (US) and ARFI imaging in papillary thyroid microcarcinoma (PTMC). The independent risk factors for predicting PTMC were evaluated.Results. The mean SWV value of benign and malignant thyroid nodules were 2.57 ± 0.79 m/s (range: 0.90–4.92 m/s) and 3.88 ± 2.24 m/s (range: 1.49–9.00 m/s) (P=0.000). Az for VTI elastography score was higher than that for hypoechoic, absence of halo sign, and type III vascularity (P<0.05). The optimal cut-offs for VTI elastography score and SWV were score 4 and 3.10 m/s. Gender, hypoechoic, taller than wide, VTI elastography score ≥ 4, and SWV > 3.10 m/s had been found to be independent risk factors for predicting PTMC.Conclusion. ARFI elastography can provide elasticity information of PTMC quantitatively (VTQ) and directly reflects the overall elastic properties (VTI). Gender, hypoechogenicity, taller than wide, VTI elastography score ≥ 4, and SWV > 3.10 m/s are independent risk factors for predicting PTMC. ARFI elastography seems to be a new tool for the diagnosis of PTMC.

Clinical Characteristics of Papillary Thyroid Microcarcinoma

2010 ◽  
Vol 53 (3) ◽  
pp. 166 ◽  
Author(s):  
Jae Won Kim ◽  
Dong Youl Lee ◽  
Young Up Cho ◽  
Chang Hyo Kim ◽  
Yoon Suk Oh ◽  
...  
Keyword(s):  
Clinical Characteristics ◽  
Papillary Thyroid Microcarcinoma ◽  
Papillary Thyroid ◽  
Thyroid Microcarcinoma
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