Diagnostic performance of shear wave elastography in the identification of malignant thyroid nodules: a meta-analysis
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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.
• 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.
KeywordsUlt rasound Elasticity imaging techniques Thyroid neoplasms Thyroid nodule Meta-analysis
- 2D SWE
2-dimensional shear wave elastography
acoustic radiation force impulse
area under the summary receiver operating characteristic curve
degrees of freedom
diagnostic odds ratio
European Federation of Societies for Ultrasound in Medicine and Biology
effective sample size
fine-needle aspirate biopsy
negative predictive value
positive predictive value
point shear wave elastography
quality assessment of diagnostic accuracy studies
receiver operating characteristic curve
shear wave elastography
shear wave velocity ratio
shear wave velocity
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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