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Performance of contrast-enhanced ultrasound (CEUS) in assessing thyroid nodules: a systematic review and meta-analysis using histological standard of reference

  • DIAGNOSTIC IMAGING IN ONCOLOGY
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Abstract

Background

The present study was undertaken to systematically review the literature on the reliability of using contrast-enhanced ultrasound (CEUS) to assess thyroid nodules. To avoid the potential bias in studies using a cytological standard of reference, here we aimed to meta-analyze data from studies adopting histological diagnosis as the gold standard.

Methods

A comprehensive literature exploration of PubMed and Scopus was conducted. The search was updated until June 2018 and references of the retrieved articles screened. Only original articles reporting the histological follow-up of nodules previously undergone CEUS evaluation were eligible for inclusion. Pooled sensitivity, specificity, PPV, and NPV of CEUS were calculated by DerSimonian and Laird method (random-effects model).

Results

The literature search retrieved 1885 articles, and 14 were included for the study. There were Chinese, Italian, German, and Austrian authors. All studies used SonoVue. The overall number of reported nodules was 1515, of which 775 were classified as positive at CEUS and 740 as negative. Pooled sensitivity, specificity, PPV, and NPV of CEUS were 85% (95% CI 83–88), 82% (95% CI 77–87), 83% (95% CI 77–88), and 85% (95% CI 81–88), respectively. Moderate inconsistency was present for specificity and PPV. There was publication bias for sensitivity and NPV.

Conclusions

CEUS reaches good performance in discriminating between malignant and benign thyroid lesions.

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Funding

This study did not receive any fund.

Author information

Authors and Affiliations

  1. Clinic for Nuclear Medicine and Competence Center for Thyroid Diseases, Imaging Institute of Southern Switzerland, Ente Ospedaliero Cantonale, Bellinzona, Switzerland

    Pierpaolo Trimboli & Luca Giovanella

  2. Faculty of Biomedical Sciences, Università della Svizzera Italiana (USI), Lugano, Switzerland

    Pierpaolo Trimboli

  3. Department of Emergency and Organ Transplantation, Section of Internal Medicine, Endocrinology, Andrology and Metabolic Diseases, University of Bari Aldo Moro, Bari, Italy

    Marco Castellana & Francesco Giorgino

  4. Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Latina, Italy

    Camilla Virili

  5. Norwegian PSC Research Center, Department of Transplantation Medicine, Division of Cancer Medicine, Surgery, Inflammatory Diseases and Transplantation, Oslo University Hospital, Oslo, Norway

    Roald Flesland Havre

  6. Department of Mechanical and Aerospace Engineering, Sapienza University of Rome, Rome, Italy

    Fabiano Bini & Franco Marinozzi

  7. Department of Radiological Sciences, Policlinico Umberto I, Sapienza University, Rome, Italy

    Ferdinando D’Ambrosio

  8. Department of Biomedical Imaging and Image-Guided Therapy, Medical University of Vienna, Vienna General Hospital, Währingergürtel, Vienna, Austria

    Helmut Prosch

  9. Department of Translational and Precision Medicine, Sapienza University, Rome, Italy

    Giorgio Grani

  10. Diagnostic Radiology Institute Paula Stradina Clinical University Hospital, Radiology Research Laboratory, University of Latvia, Riga Stradins University, Riga, Latvia

    Maija Radzina

  11. Department of Imaging Diagnostics, Policlinico Umberto I, University Sapienza, Rome, Italy

    Vito Cantisani

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  1. Pierpaolo Trimboli
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Corresponding author

Correspondence to Vito Cantisani.

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Conflict of interest

VC: speakers for Bracco, Samsung and Canon. All the other authors have nothing to disclose.

Human and animals rights

The present meta-analysis was performed using data extracted from published papers. All procedures were in accordance with the 1964 Helsinki declaration and its later amendments.

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The present meta-analysis was performed using data extracted from published papers. Informed consent was obtained from authors of included papers.

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Trimboli, P., Castellana, M., Virili, C. et al. Performance of contrast-enhanced ultrasound (CEUS) in assessing thyroid nodules: a systematic review and meta-analysis using histological standard of reference. Radiol med 125, 406–415 (2020). https://doi.org/10.1007/s11547-019-01129-2

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  • DOI: https://doi.org/10.1007/s11547-019-01129-2

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