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Diagnostic performance of 99mTc-MIBI scan in predicting the malignancy of thyroid nodules: a meta-analysis

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Abstract

Several studies have investigated the diagnostic performance of 99mTc-MIBI scan in the evaluation of thyroid nodules suspicious for malignancy with conflicting results. The aim of our study is to meta-analyze published data on this topic. A comprehensive literature search of studies published through December 2012 regarding the diagnostic performance of 99mTc-MIBI scan in the evaluation of thyroid nodules suspicious for malignancy was carried out. Pooled sensitivity and specificity of 99mTc-MIBI scan on a per lesion-based analysis and the area under the ROC curve were calculated. Pathological reports of thyroid nodules were considered as reference standard. Twenty-one studies were included in the meta-analysis. Pooled sensitivity and specificity of 99mTc-MIBI scan in detecting malignant thyroid nodules were 85.1 % [95 % confidence interval (95 % CI): 81.1–88.5 %] and 45.7 % (95 % CI: 42.7–48.7 %), respectively, on a per lesion-based analysis, irrespective of eventual results of previous technetium pertechnetate (99mTcO4) or iodine-123 (123I) scan. The area under the ROC curve was 0.78. A sub-analysis restricted to data on hypofunctioning nodules on 99mTcO4 or 123I scans was performed: pooled sensitivity and specificity of 99mTc-MIBI scan in these nodules were 82.1 % (95 % CI: 77.2–86.3 %) and 62.8 % (95 % CI: 58.9–66.7 %), respectively, on a per lesion-based analysis. The area under the ROC curve was 0.81. 99mTc-MIBI scan is a sensitive diagnostic tool in predicting the malignancy of thyroid nodules. Therefore, this imaging method could be helpful in patients with thyroid nodules in which malignancy is suspected on the basis of conventional diagnostic techniques. Higher specificity can be reached when hypofunctioning thyroid nodules are considered.

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Authors and Affiliations

  1. Department of Nuclear Medicine, Oncology Institute of Southern Switzerland, via Ospedale 12, 6500, Bellinzona, Switzerland

    Giorgio Treglia, Luca Ceriani & Luca Giovanella

  2. Institute of Nuclear Medicine, Catholic University of Rome, Rome, Italy

    Carmelo Caldarella & Massimo Salvatori

  3. Department of Clinical and Biological Sciences, University of Turin, Turin, Italy

    Enrico Saggiorato & Fabio Orlandi

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  1. Giorgio Treglia
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  2. Carmelo Caldarella
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Correspondence to Giorgio Treglia.

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Giorgio Treglia and Carmelo Caldarella equally contributed to this article sharing the first authorship.

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Treglia, G., Caldarella, C., Saggiorato, E. et al. Diagnostic performance of 99mTc-MIBI scan in predicting the malignancy of thyroid nodules: a meta-analysis. Endocrine 44, 70–78 (2013). https://doi.org/10.1007/s12020-013-9932-z

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