Association Between BRAF V600E Mutation and the American College of Radiology Thyroid Imaging, Reporting and Data System in Solitary Papillary Thyroid Carcinoma.

Rationale and Objectives: The purpose of this study was to evaluate the associations between BRAF ^V600E mutation, the American College of Radiology (ACR) thyroid imaging, reporting and data system (TI-RADS) on ultrasound and clinicopathological characteristics in patients with a solitary papillary thyroid carcinoma (PTC).
Materials and Methods: This retrospective study included 397 patients with a solitary PTC, proved pathologically. BRAF ^V600E mutation status was detected in postoperative samples by real-time fluorescent polymerase chain reaction. Associations of BRAF ^V600E mutation with the ACR TI-RADS and clinicopathological characteristics were analyzed.
Results: In this study, the incidence of BRAF ^V600E mutation was 81.4% (323/397) in patients with a solitary PTC. Univariate analyses showed that BRAF ^V600E mutation was significantly associated with margin, higher ACR TI-RADS point scores, and Hashimoto's thyroiditis. In multivariate analyses, lobulated or irregular margin was independently associated with BRAF ^V600E mutation in total solitary PTC. Furthermore, both in total solitary PTC and papillary thyroid microcarcinoma, BRAF ^V600E mutation was associated with ACR TI-RADS point scores, which was positively correlated with the risk of BRAF ^V600E mutation. There was no significant relationship between BRAF ^V600E mutation and ACR TI-RADS point scores in PTC >10 mm. In addition, Hashimoto's thyroiditis had a significant negative association with BRAF ^V600E mutation.
Conclusion: A lobulated or irregular margin of the thyroid nodule is independently associated with BRAF ^V600E mutation in patients with PTC. In addition, higher ACR TI-RADS point scores is an independent risk factor for BRAF ^V600E mutation, and ACR TI-RADS point scores is positively associated with the risk of BRAF ^V600E mutation in solitary PTC, especially in papillary thyroid microcarcinoma. Our findings may be helpful for preoperative identification and medical management of PTC patients with BRAF ^V600E mutation.
(Copyright © 2018 The Association of University Radiologists. Published by Elsevier Inc. All rights reserved.)