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Meta-Analysis
. 2024 Jun 1;14(1):12605.
doi: 10.1038/s41598-024-63420-1.

Diagnostic value of combined ultrasound contrast and elastography for differentiating benign and malignant thyroid nodules: a meta-analysis

Funing Liu  1 , Yihan Wang  2 , Yu Xiong  1 , Xin Li  3 , Jun Yao  4 , Hao Ju  5 , Fu Ren  6   7   8 , Luwei Zhang  9 , Hongbo Wang  10   11   12
Affiliations
Meta-Analysis

Diagnostic value of combined ultrasound contrast and elastography for differentiating benign and malignant thyroid nodules: a meta-analysis

Funing Liu et al. Sci Rep. .

Abstract

The diagnostic value of contrast-enhanced ultrasound combined with ultrasound elastography for benign and malignant thyroid nodules is still controversial, so we used meta-analysis to seek controversial answers. The PubMed, OVID, and CNKI databases were searched according to the inclusion and exclusion criteria. The literature was selected from the establishment of each database to February 2024. The QUADAS-2 tool assessed diagnostic test accuracy. SROC curves and Spearman's correlation coefficient were made by Review Manager 5.4 software to assess the presence of threshold effects in the literature. Meta-Disc1.4 software was used for Cochrane-Q and χ2 tests, which be used to evaluate heterogeneity, with P-values and I2 indicating heterogeneity levels. The appropriate effect model was selected based on the results of the heterogeneity test. Stata18.0 software was used to evaluate publication bias. The diagnostic accuracy of contrast-enhanced ultrasound combined with ultrasound elastography for benign and malignant thyroid nodules was evaluated by calculating the combined sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, DOR, and area under the SROC curve. A total of 31 studies included 3811 patients with 4718 nodules were analyzed. There is no heterogeneity caused by the threshold effect, but there is significant non-threshold heterogeneity. Combined diagnostic metrics were: sensitivity = 0.93, specificity = 0.91, DOR = 168.41, positive likelihood ratio = 10.60, and negative likelihood ratio = 0.07. The SROC curve area was 0.97. Contrast-enhanced ultrasound and elastography show high diagnostic accuracy for thyroid nodules, offering a solid foundation for early diagnosis and treatment.Trial registration. CRD42024509462.

Keywords: Contrast-enhanced ultrasound; Meta-analysis; Thyroid nodules; Ultrasonic elastography.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Figure 1
Figure 1
Flow chart of literature screening.
Figure 2
Figure 2
Methodological quality of the 31 included studies. (A) Methodological quality summary (B).
Figure 3
Figure 3
Comprehensive DOR of the 31 included studies.
Figure 4
Figure 4
Forest plots of sensitivity (SEN) and specificity (SPE) with corresponding 95% CIs.
Figure 5
Figure 5
Forest plots of the diagnostic OR (DOR) with corresponding 95% CIs.
Figure 6
Figure 6
The funnel plot of publication bias.
See this image and copyright information in PMC

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References

    1. Pemayun TGD. Current diagnosis and management of thyroid nodules. Acta Med. Indones. 2016;48:247–257. - PubMed
    1. Durante C, et al. The diagnosis and management of thyroid nodules: A review. JAMA. 2018;319:914–924. doi: 10.1001/jama.2018.0898. - DOI - PubMed
    1. Grani G, Sponziello M, Pecce V, Ramundo V, Durante C. Contemporary thyroid nodule evaluation and management. J. Clin. Endocrinol. Metab. 2020;105:2869–2883. doi: 10.1210/clinem/dgaa322. - DOI - PMC - PubMed
    1. Hu X, Liu Y, Qian L. Diagnostic potential of real-time elastography (RTE) and shear wave elastography (SWE) to differentiate benign and malignant thyroid nodules: A systematic review and meta-analysis. Medicine. 2017;96:e8282. doi: 10.1097/MD.0000000000008282. - DOI - PMC - PubMed
    1. Gharib H, et al. American association of clinical endocrinologists, american college of endocrinology, and associazione medici endocrinologi medical guidelines for clinical practice for the diagnosis and management of thyroid nodules–2016 update. Endocr. Pract. 2016;22:622–639. doi: 10.4158/EP161208.GL. - DOI - PubMed

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