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Open Access 17-06-2024 | Original Article

The value of ACR, European, Korean, and ATA ultrasound risk stratification systems combined with RAS mutations for detecting thyroid carcinoma in cytologically indeterminate and suspicious for malignancy thyroid nodules

Authors: Lorenzo Scappaticcio, Nicole Di Martino, Paola Caruso, Pamela Ferrazzano, Federica Zito Marino, Eduardo Clery, Alessandro Cioce, Giovanni Cozzolino, Maria Ida Maiorino, Giovanni Docimo, Pierpaolo Trimboli, Renato Franco, Katherine Esposito, Giuseppe Bellastella

Published in: Hormones

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Abstract

Purpose

The aim of this study was to evaluate the diagnostic value of four commonly utilized ultrasound (US) RSSs, namely, the American College of Radiology [ACR], European [EU], Korean [K] TI-RADSs and American Thyroid Association [ATA] US-based RSS criteria, in combination with activating point mutations of the RAS genes (NRAS, HRAS, and KRAS) for detection of thyroid carcinoma in cytologically indeterminate and suspicious for malignancy thyroid nodules.

Methods

We retrospectively analyzed cytologically indeterminate and suspicious for malignancy thyroid nodules which underwent US, molecular testing and surgery between September 1, 2018, and December 31, 2023. Receiver operating characteristic (ROC) curves were generated, and the area under the curve (AUC, 95% confidence interval [CI]) was calculated.

Results

A total of 100 cytologically indeterminate and 24 suspicious for malignancy thyroid nodules were analyzed. Compared to the four US-based RSSs alone, the diagnostic value of the four US-based RSSs combined with RAS mutations did not significantly improved (cytologically indeterminate, AUC [95% CI] 0.6 [0.5–0.7] and 0.6 [0.5–0.7], respectively, p = 0.70; cytologically suspicious for malignancy, AUC [95% CI] 0.7 [0.5–0.9] and 0.8 [0.6–0.9], respectively, p = 0.23).

Conclusions

The diagnostic value of the four main US-based RSSs (ACR, EU, K, and ATA) was not improved in conjunction with the evaluation of RAS mutations for preoperative risk stratification of cytologically indeterminate thyroid nodules.

Clinical relevance statement

In cytologically indeterminate nodules categorized according to US-based RSSs, isolated RAS positivity does not reliably distinguish between benignity and malignancy.
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Metadata
Title
The value of ACR, European, Korean, and ATA ultrasound risk stratification systems combined with RAS mutations for detecting thyroid carcinoma in cytologically indeterminate and suspicious for malignancy thyroid nodules
Authors
Lorenzo Scappaticcio
Nicole Di Martino
Paola Caruso
Pamela Ferrazzano
Federica Zito Marino
Eduardo Clery
Alessandro Cioce
Giovanni Cozzolino
Maria Ida Maiorino
Giovanni Docimo
Pierpaolo Trimboli
Renato Franco
Katherine Esposito
Giuseppe Bellastella
Publication date
17-06-2024
Publisher
Springer International Publishing
Published in
Hormones
Print ISSN: 1109-3099
Electronic ISSN: 2520-8721
DOI
https://doi.org/10.1007/s42000-024-00573-8
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