Association Between BRAF 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 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 mutation status was detected in postoperative samples by real-time fluorescent polymerase chain reaction. Associations of BRAF mutation with the ACR TI-RADS and clinicopathological characteristics were analyzed.

Results: In this study, the incidence of BRAF mutation was 81.4% (323/397) in patients with a solitary PTC. Univariate analyses showed that BRAF 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 mutation in total solitary PTC. Furthermore, both in total solitary PTC and papillary thyroid microcarcinoma, BRAF mutation was associated with ACR TI-RADS point scores, which was positively correlated with the risk of BRAF mutation. There was no significant relationship between BRAF mutation and ACR TI-RADS point scores in PTC >10 mm. In addition, Hashimoto's thyroiditis had a significant negative association with BRAF mutation.

Conclusion: A lobulated or irregular margin of the thyroid nodule is independently associated with BRAF mutation in patients with PTC. In addition, higher ACR TI-RADS point scores is an independent risk factor for BRAF mutation, and ACR TI-RADS point scores is positively associated with the risk of BRAF 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 mutation.