131 Diagnostic utility of molecular and imaging biomarkers 2 Figure 18. SROC curve of RAS mutation analysis – Bethesda IV Summary receiver operating characteristic plot showing sensitivity versus 1-specificity of RAS mutation analysis in Bethesda IV thyroid nodules with available histopathology. AUC = 0.94 (95% CI: 0.92-0.96). AUC, area under the curve; HSROC, hierarchical summary receiver operating characteristic. Table 13. Estimated pooled test performance of HRAS, KRAS and NRAS mutation analysis in indeterminate thyroid nodules FN: false negative. FP: false positive. LR+: positive likelihood ratio. LR-: negative likelihood ratio. nH: number of indeterminate nodules with conclusive index test and histopathological follow-up. TN: true negative. TP: true positive. ni TP FP FN TN sensitivity (95% CI), % specificity (95% CI), % LR+ (95% CI), % LR- (95% CI), % HRAS 1,554 26 16 403 1,109 3.8 (1.5-9.4) 99.5 (97.4-99.9) 7.81 (1.44-42.5) 0.97 (0.93-1.00) KRAS 1,554 17 6 412 1,119 3.1 (0.0-85.1) 99.5 (60.7-100) 5.69 (0.01-5,853) 0.97 (0.83-1.14) NRAS 1,554 73 38 356 1,087 13.8 (8.9-20.9) 97.0 (93.9-98.6) 4.65 (2.01-10.74) 0.89 (0.83-0.95) All (14 studies) 1,554 116 60 313 1,065 24.1 (15.2-35.8) 94.3 (90.7-96.6) 4.24 (2.23-8.07) 0.80 (0.70-0.92)
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