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Purpose: We investigated the merit of ultrasound (US) features and BRAFV600E mutationas an additional study of cytology and compared the diagnostic performances of cytology alone, cytology with US correlation, cytology with BRAFV600E mutation, and a combination of cytology, US, and BRAFV600E mutation all together. Materials and Methods: This study included 185 patients (mean age, 48.4 years; range 20--77 years) with 191 thyroid nodules who underwent US-guided fine-needle aspiration (FNA) with an additional BRAFV600E mutation test. Three radiologists highly experiencedin thyroid imaging retrospectively reviewed US images and classified each nodule into two categories (positive for malignancy or negative for malignancy). Interobservervariability (IOV) of US assessment between the three readers was estimatedusing the generalized kappa statistic of Landis and Koch. We also calculated the diagnostic performances of these studies. Results: There were 131 cases of malignancy(131/191, 68.6%) and 60 cases of benign nodules (60/191, 31.4%). In terms of IOV of US assessment, the generalized kappa value was 0.242, indicating fair agreementwas reached. The combination of cytology with BRAFV600E showed higher specificity (100%) and positive predictive value (PPV) (100%) compared to the combinationof cytology, BRAFV600E, and US (specificity 28.3%, 66.7%, 68.3%; PPV 74.6%, 86.6%, 86.8%, respectively; p<0.001). However, cytology with BRAFV600E showed lower sensitivity (84.7%) than cytology with BRAFV600E and US (96.2%, 98.5%, 95.4%, respectively; p<0.001). Conclusion: Considering the diagnostic performanceand low reproducibility of US, the combination of FNA with BRAFV600E is the most reliable and objective method for diagnosing thyroid malignancy.

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참고문헌 (25건) : 자료제공( 네이버학술정보 )

참고문헌 목록에 대한 테이블로 번호, 참고문헌, 국회도서관 소장유무로 구성되어 있습니다.
번호 참고문헌 국회도서관 소장유무
1 The diagnostic accuracy of ultrasound-guided fine-needle aspiration biopsy and the sonographic differences between benign and malignant thyroid nodules 3 cm or larger. 네이버 미소장
2 Reclassifying formerly indeterminate thyroid FNAs using the Bethesda system reduces the number of inconclusive cases. 네이버 미소장
3 The diagnostic values of ultrasound and ultrasound-guided fine needle aspiration in subcentimeter-sized thyroid nodules. 네이버 미소장
4 Nikiforov YE, Nikiforova MN. Molecular genetics and diagnosis of thyroid cancer. Nat Rev Endocrinol 2011;7:569-80. 미소장
5 Cost impact of molecular testing for indeterminate thyroid nodule fine-needle aspiration biopsies. 네이버 미소장
6 The BRAF(V600E) mutation is associated with malignant ultrasonographic features in thyroid nodules. 네이버 미소장
7 Cost-effectiveness of a novel molecular test for cytologically indeterminate thyroid nodules. 네이버 미소장
8 BRAF^V^6^0^0^E Mutation Testing in Fine Needle Aspirates of Thyroid Nodules: Potential Value of Real-Time PCR 네이버 미소장
9 Role of ultrasound diagnosis in assessing and managing thyroid nodules with inadequate cytology. 네이버 미소장
10 Kwak JY, Kim EK, Kim HJ, Kim MJ, Son EJ, Moon HJ. How to combine ultrasound and cytological information in decision making about thyroid nodules. Eur Radiol 2009;19:1923-31. 미소장
11 Choi YS, Hong SW, Kwak JY, Moon HJ, Kim EK. Clinical and ultrasonographic findings affecting nondiagnostic results upon the second fine needle aspiration for thyroid nodules. Ann Surg Oncol 2012;19:2304-9. 미소장
12 Interobserver and intraobserver variations in ultrasound assessment of thyroid nodules. 네이버 미소장
13 Kim HG, Kwak JY, Kim EK, Choi SH, Moon HJ. Man to man training: can it help improve the diagnostic performances and interobserver variabilities of thyroid ultrasonography in residents? Eur J Radiol 2012;81:e352-6. 미소장
14 Benign and malignant thyroid nodules: US differentiation--multicenter retrospective study. 네이버 미소장
15 Revised American Thyroid Association management guidelines for patients with thyroid nodules and differentiated thyroid cancer. 네이버 미소장
16 American Association of Clinical Endocrinologists and Associazione Medici Endocrinologi Medical Guidelines for Clinical Practice for the Diagnosis and Management of Thyroid Nodules 네이버 미소장
17 The Measurement of Observer Agreement for Categorical Data 네이버 미소장
18 Molecular testing for somatic mutations improves the accuracy of thyroid fine-needle aspiration biopsy. 네이버 미소장
19 Molecular testing for mutations in improving the fine-needle aspiration diagnosis of thyroid nodules. 네이버 미소장
20 Modifications in the papillary thyroid cancer gene profile over the last 15 years. 네이버 미소장
21 Surgical Results of Thyroid Nodules according to a Management Guideline Based on the BRAF^V^6^0^0^E Mutation Status 네이버 미소장
22 BRAF V600E mutation analysis of thyroid nodules needle aspirates in relation to their ultrasongraphic classification: a potential guide for selection of samples for molecular analysis. 네이버 미소장
23 BRAF mutation analysis and sonography as adjuncts to fine-needle aspiration cytology of papillary thyroid carcinoma: their relationships and roles. 네이버 미소장
24 Observer Variability and the Performance between Faculties and Residents: US Criteria for Benign and Malignant Thyroid Nodules 소장
25 Anaplastic thyroid cancer: ultrasonographic findings and the role of ultrasonography-guided fine needle aspiration biopsy. 소장

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