Cargando…

The analysis and validation of the prediction value of conventional and contrast-enhanced ultrasonography for BRAF mutant papillary thyroid microcarcinoma

BACKGROUND: BRAF has certain potential in distinguishing aggressive papillary thyroid microcarcinoma (PTMC). However, it is not recommended to conduct BRAF analysis for all suspicious thyroid nodules <1 cm. In order to investigate the ultrasound value indicating BRAF mutation among PTMC, which sh...

Descripción completa

Detalles Bibliográficos
Autores principales: Li, Huilin, Ma, Jiaojiao, Xi, Xuehua, Tang, Jiajia, Wang, Linping, Wang, Liangkai, Lin, Shengtao, Zhang, Bo
Formato: Online Artículo Texto
Lenguaje:English
Publicado: AME Publishing Company 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9638797/
https://www.ncbi.nlm.nih.gov/pubmed/36353582
http://dx.doi.org/10.21037/gs-22-493
_version_ 1784825504696631296
author Li, Huilin
Ma, Jiaojiao
Xi, Xuehua
Tang, Jiajia
Wang, Linping
Wang, Liangkai
Lin, Shengtao
Zhang, Bo
author_facet Li, Huilin
Ma, Jiaojiao
Xi, Xuehua
Tang, Jiajia
Wang, Linping
Wang, Liangkai
Lin, Shengtao
Zhang, Bo
author_sort Li, Huilin
collection PubMed
description BACKGROUND: BRAF has certain potential in distinguishing aggressive papillary thyroid microcarcinoma (PTMC). However, it is not recommended to conduct BRAF analysis for all suspicious thyroid nodules <1 cm. In order to investigate the ultrasound value indicating BRAF mutation among PTMC, which showed discrepancy in previous studies, we aimed to establish a predictive model based on conventional and contrast-enhanced ultrasonography. METHODS: We consecutively and retrospectively enrolled patients with PTMC who underwent fine-needle aspiration biopsy (FNAB) at our hospital between January 2020 and January 2021. All PTMC patients received conventional and contrast-enhanced ultrasound prior to FNAB, samples gained went through cytological analysis and BRAF testing subsequently. The following conventional ultrasonography data were analyzed: maximum diameter, echogenicity, echo homogeneity, echogenic foci, location, shape, boundary, aspect ratio, and blood flow volume. Moreover, the following contrast-enhanced ultrasonography data were also analyzed: degree, homogeneity, completeness, and enhancement method. Time-intensity curves from contrast-enhanced ultrasonography were analyzed using VueBox software for different regions of interest, including the entire tumor, the area of strongest enhancement, and healthy thyroid glands. The independent risk factors for BRAF mutation in PTMC were identified using univariate and multivariate logistic regression. Their predictive value was tested through internal validation. RESULTS: Of the 103 PTMC lesions analyzed, 72 involved BRAF mutations. Five independent ultrasonographic risk factors for BRAF mutation were identified: relative time to peak value in the area of strongest enhancement, unclear boundary, location adjacent to thyroid capsules, maximum diameter >0.5 cm, and punctate echogenic foci. A predictive model based on these factors was able to diagnose BRAF mutations in PTMC, with an area under the curve (AUC) of 0.824. During internal validation, this model showed an AUC of 0.723. CONCLUSIONS: Conventional and contrast-enhanced ultrasound characteristics, including relative time to peak value in the area of strongest enhancement, unclear boundary, location adjacent to thyroid capsules, maximum diameter >0.5 cm, and punctate echogenic foci, may be useful for predicting BRAF mutations in patients with PTMC.
format Online
Article
Text
id pubmed-9638797
institution National Center for Biotechnology Information
language English
publishDate 2022
publisher AME Publishing Company
record_format MEDLINE/PubMed
spelling pubmed-96387972022-11-08 The analysis and validation of the prediction value of conventional and contrast-enhanced ultrasonography for BRAF mutant papillary thyroid microcarcinoma Li, Huilin Ma, Jiaojiao Xi, Xuehua Tang, Jiajia Wang, Linping Wang, Liangkai Lin, Shengtao Zhang, Bo Gland Surg Original Article BACKGROUND: BRAF has certain potential in distinguishing aggressive papillary thyroid microcarcinoma (PTMC). However, it is not recommended to conduct BRAF analysis for all suspicious thyroid nodules <1 cm. In order to investigate the ultrasound value indicating BRAF mutation among PTMC, which showed discrepancy in previous studies, we aimed to establish a predictive model based on conventional and contrast-enhanced ultrasonography. METHODS: We consecutively and retrospectively enrolled patients with PTMC who underwent fine-needle aspiration biopsy (FNAB) at our hospital between January 2020 and January 2021. All PTMC patients received conventional and contrast-enhanced ultrasound prior to FNAB, samples gained went through cytological analysis and BRAF testing subsequently. The following conventional ultrasonography data were analyzed: maximum diameter, echogenicity, echo homogeneity, echogenic foci, location, shape, boundary, aspect ratio, and blood flow volume. Moreover, the following contrast-enhanced ultrasonography data were also analyzed: degree, homogeneity, completeness, and enhancement method. Time-intensity curves from contrast-enhanced ultrasonography were analyzed using VueBox software for different regions of interest, including the entire tumor, the area of strongest enhancement, and healthy thyroid glands. The independent risk factors for BRAF mutation in PTMC were identified using univariate and multivariate logistic regression. Their predictive value was tested through internal validation. RESULTS: Of the 103 PTMC lesions analyzed, 72 involved BRAF mutations. Five independent ultrasonographic risk factors for BRAF mutation were identified: relative time to peak value in the area of strongest enhancement, unclear boundary, location adjacent to thyroid capsules, maximum diameter >0.5 cm, and punctate echogenic foci. A predictive model based on these factors was able to diagnose BRAF mutations in PTMC, with an area under the curve (AUC) of 0.824. During internal validation, this model showed an AUC of 0.723. CONCLUSIONS: Conventional and contrast-enhanced ultrasound characteristics, including relative time to peak value in the area of strongest enhancement, unclear boundary, location adjacent to thyroid capsules, maximum diameter >0.5 cm, and punctate echogenic foci, may be useful for predicting BRAF mutations in patients with PTMC. AME Publishing Company 2022-10 /pmc/articles/PMC9638797/ /pubmed/36353582 http://dx.doi.org/10.21037/gs-22-493 Text en 2022 Gland Surgery. All rights reserved. https://creativecommons.org/licenses/by-nc-nd/4.0/Open Access Statement: This is an Open Access article distributed in accordance with the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International License (CC BY-NC-ND 4.0), which permits the non-commercial replication and distribution of the article with the strict proviso that no changes or edits are made and the original work is properly cited (including links to both the formal publication through the relevant DOI and the license). See: https://creativecommons.org/licenses/by-nc-nd/4.0 (https://creativecommons.org/licenses/by-nc-nd/4.0/) .
spellingShingle Original Article
Li, Huilin
Ma, Jiaojiao
Xi, Xuehua
Tang, Jiajia
Wang, Linping
Wang, Liangkai
Lin, Shengtao
Zhang, Bo
The analysis and validation of the prediction value of conventional and contrast-enhanced ultrasonography for BRAF mutant papillary thyroid microcarcinoma
title The analysis and validation of the prediction value of conventional and contrast-enhanced ultrasonography for BRAF mutant papillary thyroid microcarcinoma
title_full The analysis and validation of the prediction value of conventional and contrast-enhanced ultrasonography for BRAF mutant papillary thyroid microcarcinoma
title_fullStr The analysis and validation of the prediction value of conventional and contrast-enhanced ultrasonography for BRAF mutant papillary thyroid microcarcinoma
title_full_unstemmed The analysis and validation of the prediction value of conventional and contrast-enhanced ultrasonography for BRAF mutant papillary thyroid microcarcinoma
title_short The analysis and validation of the prediction value of conventional and contrast-enhanced ultrasonography for BRAF mutant papillary thyroid microcarcinoma
title_sort analysis and validation of the prediction value of conventional and contrast-enhanced ultrasonography for braf mutant papillary thyroid microcarcinoma
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9638797/
https://www.ncbi.nlm.nih.gov/pubmed/36353582
http://dx.doi.org/10.21037/gs-22-493
work_keys_str_mv AT lihuilin theanalysisandvalidationofthepredictionvalueofconventionalandcontrastenhancedultrasonographyforbrafmutantpapillarythyroidmicrocarcinoma
AT majiaojiao theanalysisandvalidationofthepredictionvalueofconventionalandcontrastenhancedultrasonographyforbrafmutantpapillarythyroidmicrocarcinoma
AT xixuehua theanalysisandvalidationofthepredictionvalueofconventionalandcontrastenhancedultrasonographyforbrafmutantpapillarythyroidmicrocarcinoma
AT tangjiajia theanalysisandvalidationofthepredictionvalueofconventionalandcontrastenhancedultrasonographyforbrafmutantpapillarythyroidmicrocarcinoma
AT wanglinping theanalysisandvalidationofthepredictionvalueofconventionalandcontrastenhancedultrasonographyforbrafmutantpapillarythyroidmicrocarcinoma
AT wangliangkai theanalysisandvalidationofthepredictionvalueofconventionalandcontrastenhancedultrasonographyforbrafmutantpapillarythyroidmicrocarcinoma
AT linshengtao theanalysisandvalidationofthepredictionvalueofconventionalandcontrastenhancedultrasonographyforbrafmutantpapillarythyroidmicrocarcinoma
AT zhangbo theanalysisandvalidationofthepredictionvalueofconventionalandcontrastenhancedultrasonographyforbrafmutantpapillarythyroidmicrocarcinoma
AT lihuilin analysisandvalidationofthepredictionvalueofconventionalandcontrastenhancedultrasonographyforbrafmutantpapillarythyroidmicrocarcinoma
AT majiaojiao analysisandvalidationofthepredictionvalueofconventionalandcontrastenhancedultrasonographyforbrafmutantpapillarythyroidmicrocarcinoma
AT xixuehua analysisandvalidationofthepredictionvalueofconventionalandcontrastenhancedultrasonographyforbrafmutantpapillarythyroidmicrocarcinoma
AT tangjiajia analysisandvalidationofthepredictionvalueofconventionalandcontrastenhancedultrasonographyforbrafmutantpapillarythyroidmicrocarcinoma
AT wanglinping analysisandvalidationofthepredictionvalueofconventionalandcontrastenhancedultrasonographyforbrafmutantpapillarythyroidmicrocarcinoma
AT wangliangkai analysisandvalidationofthepredictionvalueofconventionalandcontrastenhancedultrasonographyforbrafmutantpapillarythyroidmicrocarcinoma
AT linshengtao analysisandvalidationofthepredictionvalueofconventionalandcontrastenhancedultrasonographyforbrafmutantpapillarythyroidmicrocarcinoma
AT zhangbo analysisandvalidationofthepredictionvalueofconventionalandcontrastenhancedultrasonographyforbrafmutantpapillarythyroidmicrocarcinoma