The aim of this study was to evaluate the diagnostic value of four commonly utilized ultrasound RSSs (the American College of Radiology [ACR], European [EU], Korean [K] TI-RADSs and American Thyroid Association [ATA] US-based RSS criteria) [1, 24–26] in combination with activating point mutations of the RAS gene (NRAS, HRAS, and KRAS) for detecting thyroid carcinoma in cytologically indeterminate and suspicious for malignancy thyroid nodules at the authors’ institution. The gene discussed is HRAS; the disease is thyroid nodule.