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European Radiology
Published in: European Radiology 12/2020

01-12-2020 | Ultrasound

Diagnostic reliability of elastography in thyroid nodules reported as indeterminate at prior fine-needle aspiration cytology (FNAC): a systematic review and Bayesian meta-analysis

Authors: Yuxuan Qiu, Zhichao Xing, Jingyan Liu, Yulan Peng, Jingqiang Zhu, Anping Su

Published in: European Radiology | Issue 12/2020

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Abstract

Objectives

To assess the diagnostic yields of elastography in thyroid nodules reported as indeterminate in FNAC according to guidelines.

Methods

Databases of Medline, Embase, and Cochrane Central were searched till 31 October 2019. Two different reviewers check the studies and extracted the data. The diagnostic accuracy and yield were quantitatively synthesized using Bayesian bivariate model in R.

Results

Twenty studies with 1734 indeterminate thyroid nodules undergoing elastography were included. The summary estimates of sensitivity and specificity were 0.766 (95% credible interval (CrI), 0.686–0.835) and 0.867 (95% CrI, 0.780–0.931), respectively. The summary estimate for diagnostic odds ratio (DOR) was 25.9 (95% CrI, 12.8–46.2). Summary receiver operating characteristic plots for elastography showed a right-diagonal curvilinear relationship, suggesting a trade-off between sensitivity and specificity, and the estimate of area under curve (AUC) was 0.743. The summary estimates for positive and negative likelihood ratios were 6.6 (95% CrI, 4.2–11.3) and 0.27 (95% CrI, 0.21–0.36), respectively.

Conclusions

Elastography had fair diagnostic yields in indeterminate thyroid nodules. Shear wave elastography and strain ratio elastography could be more efficient in diagnosis and should evolve in the next years while combing elastography with ultrasound would contribute more to sensitivity and specificity currently.

Key Points

• Elastography has fair diagnostic yields in indeterminate thyroid nodules.
• Shear wave elastography and strain ratio elastography are more efficient than real-time elastography.
• Combining elastography and other ultrasound techniques improves evaluation of indeterminate thyroid nodules.
Appendix
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Metadata
Title
Diagnostic reliability of elastography in thyroid nodules reported as indeterminate at prior fine-needle aspiration cytology (FNAC): a systematic review and Bayesian meta-analysis
Authors
Yuxuan Qiu
Zhichao Xing
Jingyan Liu
Yulan Peng
Jingqiang Zhu
Anping Su
Publication date
01-12-2020
Publisher
Springer Berlin Heidelberg
Published in
European Radiology / Issue 12/2020
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI
https://doi.org/10.1007/s00330-020-07023-0

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