Association Of The BRAF^V600E Mutation With Conventional Ultrasound And Strain Elastography Characteristics Of Thyroid Nodules

Objective:To analyze the association of conventional ultrasound and strain elastography characteristics of thyroid nodules with BRAF^V600Emutation and to evaluate the predictive value of thyroid nodule sonographic characteristics for BRAF^V600Emutation.Methods:A total of 1694 thyroid nodules from 1534 patients who underwent both fine-needle aspiration?FNA?and BRAF^V600Emutation analysis in our hospital from January 2017 to December 2018 were enrolled in the study.Conventional ultrasound features and strain elastography?SE?scores of all nodules were investigated.The nodules were categorized into two groups according to the results of the BRAF^V600Emutation,mutant group and wild-type group.Differences in sonographic characteristics between the two groups were assessed.The relationship between ultrasound features and the presence of BRAF^V600Emutation was retrospectively analyzed.Variables related to BRAF^V600Emutation were included in the multivariate logistic regression analysis to analyze the correlation between ultrasound characteristics and BRAF^V600Emutation.Results:975/1694?57.6%?nodules were mutant and 719/1694?42.4%?nodules were wild-type in this study.There were significant differences in age,nodule size,underlying echogenicity of the thyroid parenchyma,nodule number,echogenicity,pattern of nodule growth,taller-than-wide shape,blood flow distribution,halo,calcification classification,TI-RADS category and SE score between the two groups?p<0.05?.There were no significant differences in the gender,composition or other mentioned conventional ultrasound characteristics between the two groups?p>0.05?.The following sonographic features based on multivariate logistic regression analysis showed significant predictive value for BRAF^V600Emutant nodules:extraglandular growth,age 45 years or less,SE score 4 and 5,absence of halo,taller-than-wide shape,homogeneous thyroid parenchyma,and isoechogenicity were shown to be protective factor for BRAF^V600Emutation.When?3 suspicious features were present,BRAF^V600Emutation was predicted with sensitivity of 76.4%,specificity of 42.7%,and positive predictive value of 64.4%.Conclusion:The BRAF^V600Emutation was significantly associated with conventional ultrasound and strain elastography characteristics of thyroid nodules.Extraglandular growth,age45 years or less,SE score 4 and 5,absence of halo,taller-than-wide shape,and homogeneous thyroid parenchyma were independent findings for predicting thyroid nodules with BRAF^V600Emutations,and isoechogenicity were shown to be protective factor for BRAF^V600Emutation.