Thyroid nodule ultrasound accuracy in predicting thyroid malignancy based on TIRADS system

医学 甲状腺结节 诊断优势比 甲状腺 甲状腺癌 结核(地质) 细针穿刺 放射科 接收机工作特性 恶性肿瘤 荟萃分析 优势比 活检 内科学 诊断准确性 古生物学 生物
作者
Wanlu Nie,Li Zhu,Ping Yan,Jie Sun
出处
期刊:Advances in Clinical and Experimental Medicine [Wroclaw Medical University]
卷期号:31 (6): 597-606 被引量:9
标识
DOI:10.17219/acem/146776
摘要

Background. A frequent prevalence of thyroid nodules in patients prioritizes the need for an accurate method that characterizes them as benign or malignant. Fine-needle aspiration biopsy (FNAB) and thyroid ultrasonography (USG) are currently used for this purpose. However, since FNAB is complicated, time-consuming and expensive, thyroid USG, a fast and highly sensitive method, is preferably used. Although USG is reported as a suitable method for characterization of thyroid nodules, there are some contrasting studies available which report its limited use in the differentiation of benign and malignant thyroid nodules.Objectives. This meta-analysis aims to assess the accuracy of ultrasound in predicting thyroid cancer in terms of sensitivity, specificity and diagnostic odds ratios (ORs) for positive and negative results.Material and Methods. Systematic and extensive literature search on the use of ultrasound (US) to predict thyroid cancer was conducted in the databases of Scopus, CINAHL (via EBSCO), MEDLINE (via PubMed), and Web of Science, covering the period from 2010 till 2021. The morphological features of thyroid nodules observed during the USG were analyzed based on Thyroid Imaging Reporting And Data System (TIRADS) guidelines. The accuracy of thyroid US was determined using parameters such as sensitivity, specificity, positive likelihood ratio (PLR), negative likelihood ratio (NLR), and diagnostic ORs. Moreover, the respective forest plot and hierarchical summary receiver operating characteristics (HSROC) curve were plotted.Results. A total of 2765 reference studies were examined, and among them, 15 relevant references were selected. The selected studies were heterogeneous and included retrospective and prospective studies. The risk of publication bias is low as the p-value for both Egger's and Begg's tests is >0.05. The overall sensitivity of 92.53% (95% confidence interval (95% CI): [84.55%; 96.33%]), specificity of 33.88% (95% CI: [23.16%; 45.53%]) and diagnostic OR of 12.36 (95% CI: [3.90%; 54.11%]) are achieved. These results were statistically significant with a p-value < 0.001 and are predictive of US accuracy in detecting cancer.Conclusion. The present meta-analysis, on the basis of statistically significant results, demonstrated the high accuracy of thyroid ultrasound in detection of malignant nature of nodules in patients suspected with a worrisome thyroid nodule.

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