Department of Ultrasound, Bishan Hospital of Chongqing, Bishan Hospital of Chongqing Medical University, Chongqing, China.
Department of Ultrasound, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China.
Ultrasound Q. 2023 Dec 1;39(4):199-205. doi: 10.1097/RUQ.0000000000000647.
This prospective study aimed to investigate the combination of shear wave elastography (SWE) and BRAFV600E mutation testing for the diagnosis of papillary thyroid carcinoma (PTC). One hundred thyroid nodules with an American College of Radiology thyroid imaging reporting and data system classification of 4 or 5 were subjected to SWE measurement, BRAFV600E genotyping, fine-needle aspiration, and surgery. Nonparametric statistical tests were used to compare the differences in the elastic parameters and BRAF genotypes between benign and malignant thyroid nodules of PTC, and receiver operating characteristic curve analysis was conducted to compare the diagnostic efficacy. In addition, the correlations between elastic parameters and BRAFV600E mutation in PTC were analyzed using binary logistic regression. The SWE, BRAFV600E, and their combination exhibited sensitivities of 72.9%, 81.3%, and 85.4%, respectively, and specificities of 66.7%, 90.3%, and 86.5%, respectively, in the diagnosis of PTC ( P < 0.05). The SWE, BRAFV600E, and their combination exhibited sensitivities of 50.0%, 24.1% and 56.3%, respectively, and specificities of 89.7%, 87.5% and 82.8%, respectively, in the diagnosis of central cervical lymph node metastasis ( P < 0.05). The combined use of SWE and BRAFV600E detection had the largest area under the curve, indicating that this combination is more effective in diagnosing PTC and lymph node metastasis in the central region than either method alone. Furthermore, Emax was positively associated with the BRAFV600E genotype. In conclusion, the combination of SWE and BRAFV600E genotype detection can improve the diagnostic efficacy for PTC. Emax can predict the BRAFV600E mutation status.
本前瞻性研究旨在探讨剪切波弹性成像（SWE）与 BRAFV600E 突变检测联合应用于甲状腺乳头状癌（PTC）的诊断。对 100 个美国放射学会甲状腺影像报告和数据系统分类为 4 或 5 级的甲状腺结节进行 SWE 测量、BRAFV600E 基因分型、细针穿刺抽吸和手术。采用非参数统计检验比较 PTC 良恶性甲状腺结节之间弹性参数和 BRAF 基因型的差异，绘制受试者工作特征曲线分析比较诊断效能。此外，采用二项逻辑回归分析 PTC 中弹性参数与 BRAFV600E 突变的相关性。SWE、BRAFV600E 及其联合检测在诊断 PTC 时的敏感性分别为 72.9%、81.3%和 85.4%，特异性分别为 66.7%、90.3%和 86.5%（P<0.05）。SWE、BRAFV600E 及其联合检测在诊断中央颈部淋巴结转移时的敏感性分别为 50.0%、24.1%和 56.3%，特异性分别为 89.7%、87.5%和 82.8%（P<0.05）。SWE 和 BRAFV600E 联合检测的曲线下面积最大，表明与单独使用任何一种方法相比，联合检测在诊断 PTC 和中央区域淋巴结转移方面更有效。此外，Emax 与 BRAFV600E 基因型呈正相关。总之，SWE 与 BRAFV600E 基因型检测联合应用可提高 PTC 的诊断效能。Emax 可预测 BRAFV600E 突变状态。
