To evaluate the diagnostic efficacy of a combined model integrating the BRAF V600E mutation and quantitative contrast-enhanced ultrasound (CEUS) parameters for differentiating benign from malignant thyroid nodules.
Key Findings:
BRAF V600E mutation was significantly more frequent in malignant nodules (64.9% vs. 3.4%; P < 0.001).
TTP was an independent predictor of malignancy in a regression model with CEUS parameters (OR = 1.075, P = 0.013).
With the addition of BRAF V600E, TTP lost significance (P > 0.05), while BRAF V600E remained significant (OR = 38.380, P = 0.001).
The combined model achieved the highest AUC of 0.855, surpassing TTP alone (AUC = 0.681) and BRAF V600E alone (AUC = 0.807) (P < 0.05).
The combined model showed higher specificity (64.9% vs. 24.1%) while maintaining comparable sensitivity (96.6% vs. 94.6%) compared to TI-RADS.
Interpretation:
The BRAF V600E mutation is a strong independent predictor of thyroid nodule malignancy, and combining it with CEUS parameters enhances diagnostic accuracy, particularly in BRAF V600E-negative cases.
Limitations:
The study is limited by its small sample size of 66 patients.
Further validation in larger cohorts is necessary to confirm findings.
Conclusion:
Integrating BRAF V600E mutation status with quantitative CEUS parameters may improve preoperative risk stratification for thyroid nodules.
