European Radiology

, Volume 24, Issue 11, pp 2729–2738 | Cite as

Diagnostic performance of shear wave elastography in the identification of malignant thyroid nodules: a meta-analysis

  • Peiliang Lin
  • Minqi Chen
  • Baoxian Liu
  • Siwen Wang
  • Xiaoxi LiEmail author



This meta-analysis aimed to assess the performance of shear wave elastography (SWE) in the identification of malignant thyroid nodules.


Web of Science, Scopus, PubMed, and the references of narrative reviews were searched for relevant studies with a publication date through October 2013. The methodological quality was assessed using QUADAS tools. Data synthesis was calculated using the bivariate mixed-effects regression model.


Of the 131 studies identified, 15 (11.5 %) were included, in which SWE, point-SWE or 2D SWE, was used to evaluate 1,867 thyroid nodules in 1,525 patients. Methodological assessment revealed study quality was moderate to high. The pooled sensitivity, specificity, and area under the summary receiver operating characteristic curve of SWE for detecting malignant thyroid nodules were 84.3 % (95 % confidence interval [CI], 76.9–89.7 %), 88.4 % (95 % CI, 84.0–91.7 %), and 93 % (95 % CI, 90–95 %), respectively. As a screening tool, positive and negative predictive values were 27.7–44.7 % and 98.1–99.1 %, respectively, calculated with a malignance prevalence of 5–10 % in thyroid nodules. A publication bias regression test revealed no significant small-study bias.


SWE is a highly accurate diagnostic modality for the identification of malignant thyroid nodules, with promise for integration into routine imaging protocols for thyroid nodules.

Key Points

Shear wave elastography (SWE) is a group of novel ultrasound-based technologies.

Meta-analysis was employed to assess relevant studies of SWE of thyroid nodules.

SWE had high sensitivity and specificity in identifying malignant thyroid nodules.

The high negative predictive value of SWE can reduce unnecessary biopsies.


Ult rasound Elasticity imaging techniques Thyroid neoplasms Thyroid nodule Meta-analysis 



2-dimensional shear wave elastography


acoustic radiation force impulse


area under the summary receiver operating characteristic curve


confidence interval


degrees of freedom


diagnostic odds ratio


European Federation of Societies for Ultrasound in Medicine and Biology


elasticity score


effective sample size


false negative


fine-needle aspirate biopsy


false positive


negative predictive value


positive predictive value


point shear wave elastography


quality assessment of diagnostic accuracy studies


receiver operating characteristic curve


strain elastography


strain ratio


shear wave elastography


shear wave velocity ratio


shear wave velocity


true negative


true positive



The scientific guarantor of this publication is Xiaoxi Li. The authors of this manuscript declare no relationships with any companies whose products or services may be related to the subject matter of the article. The authors state that this work has not received any funding. No complex statistical methods were necessary for this paper. Institutional Review Board approval and written informed consent were not required because our study was a meta-analysis based on published data.. Some study subjects or cohorts have been previously reported in the studies included in our meta-analysis. However, the results of our research based on these studies are original and have not been published or presented previously at meetings. Methodology: diagnostic or prognostic study, performed at one institution.


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Copyright information

© European Society of Radiology 2014

Authors and Affiliations

  • Peiliang Lin
    • 1
  • Minqi Chen
    • 2
  • Baoxian Liu
    • 2
  • Siwen Wang
    • 1
  • Xiaoxi Li
    • 1
    Email author
  1. 1.Department of Vascular and Thyroid SurgeryFirst Affiliated Hospital, Sun Yat-Sen UniversityGuangzhouChina
  2. 2.Department of UltrasoundFirst Affiliated Hospital, Sun Yat-Sen UniversityGuangzhouChina

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