Diagnostic performance of combination of ultrasound elastography and BRAF gene detection in malignant thyroid nodule: a retrospective study.

OBJECTIVES The aims of our study were to explore the preoperative diagnostic value of ultrasound elastography combined with BRAF gene detection in malignant thyroid nodule, and find whether shear wave elastography (SWE) combined with BRAF gene detection can improve the diagnostic sensitivity and specificity. METHODS From 1480 patients with thyroid nodule examined between January 2015 and December 2017, a retrospective analysis was performed on 161 patients who underwent thyroidectomy. Diagnosis was confirmed by postoperative pathology, including 139 malignant thyroid nodules and 22 benign thyroid nodules. All the patients underwent SWE, BRAF gene detection, and the combination for their preoperative evaluation. The sensitivities, specificities, and accuracies of SWE, BRAF gene detection, and the combination for detection of malignant thyroid nodules were calculated and then compared using Fisher's exact probability test, based on the original preoperative reports and postoperative pathology. A receiver-operating characteristic curve analysis was performed to compare the diagnostic performance of SWE, BRAF gene detection, and combination for detecting malignant thyroid nodules. RESULTS Based on the original preoperative reports and postoperative pathology, SWE, BRAF gene detection, and the combination showed sensitivities of 88.67%, 78.41%, 92.8%, and specificities of 72.77%, 77.27%, 95.45%. A correct diagnosis was obtained in 85.82%, 78.26%, 93.16% and missed diagnosis rates were 12.23%, 21.58%, and 7.19%. The sensitivities, specificities, and correct diagnosis rate in the combination group were significantly higher than any single detection method (P<0.05). The missed diagnosis rate in the combination group was significantly lower than any single detection method (P<0.05). The receptor operating characteristics curve analysis showed a significantly higher diagnostic performance for the combination than for SWE and BRAF gene detection (P<0.05). The interobserver agreement for detecting malignant thyroid nodule was better for the combination than for SWE or BRAF gene detection alone. CONCLUSION For the detection of a malignant thyroid nodule, SWE combined with BRAF gene detection was more sensitive and showed a higher diagnostic performance than SWE or BRAF gene detection alone.