Diagnostic performance of ultrasound risk stratification systems on thyroid nodules cytologically classified as indeterminate: a systematic review and meta-analysis
Purpose Ultrasound (US) risk stratification systems (RSSs) are increasingly being utilized for the optimal management of thyroid nodules, including those with indeterminate cytology. The goal of this study was to evaluate the category-based diagnostic performance of US RSSs in identifying malignancy...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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Korean Society of Ultrasound in Medicine
2023-10-01
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| Series: | Ultrasonography |
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| Online Access: | http://www.e-ultrasonography.org/upload/usg-23055.pdf |
| _version_ | 1797672650097557504 |
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| author | Zhichao Xing Yuxuan Qiu Jingqiang Zhu Anping Su Wenshuang Wu |
| author_facet | Zhichao Xing Yuxuan Qiu Jingqiang Zhu Anping Su Wenshuang Wu |
| author_sort | Zhichao Xing |
| collection | DOAJ |
| description | Purpose Ultrasound (US) risk stratification systems (RSSs) are increasingly being utilized for the optimal management of thyroid nodules, including those with indeterminate cytology. The goal of this study was to evaluate the category-based diagnostic performance of US RSSs in identifying malignancy in indeterminate nodules. Methods This systematic review and meta-analysis was registered on PROSPERO (CRD42021266195). PubMed, EMBASE, and Web of Science were searched through December 1, 2022. Original articles reporting data on the performance of US RSSs for indeterminate nodules were included. The numbers of nodules classified as true negative, true positive, false negative, and false positive were extracted. Results Thirty-three studies evaluating 7,225 indeterminate thyroid nodules were included. The diagnostic accuracy was quantitatively synthesized using a Bayesian bivariate model based on the integrated nested Laplace approximation in R. For the intermediate- to high-risk category, the sensitivity levels of the American College of Radiology, the American Thyroid Association, the European Thyroid Association, the Korean Thyroid Association/Korean Society of Thyroid Radiology, and Kwak et al. were found to be 0.80, 0.72, 0.76, 0.96, and 0.97, respectively. The corresponding specificity measurements were 0.36, 0.50, 0.49, 0.28, and 0.17. Furthermore, for the high-risk category, the sensitivity values were 0.40, 0.46, 0.55, 0.47, and 0.10, while the specificity levels were 0.91, 0.90, 0.71, 0.91, and 0.99, respectively. Conclusion The overall diagnostic performance of the US RSSs was moderate in the differentiation of indeterminate nodules. |
| first_indexed | 2024-03-11T21:33:18Z |
| format | Article |
| id | doaj.art-d64ed1ff168f4d5cb58fbaeaecfa0bf0 |
| institution | Directory Open Access Journal |
| issn | 2288-5919 2288-5943 |
| language | English |
| last_indexed | 2024-03-11T21:33:18Z |
| publishDate | 2023-10-01 |
| publisher | Korean Society of Ultrasound in Medicine |
| record_format | Article |
| series | Ultrasonography |
| spelling | doaj.art-d64ed1ff168f4d5cb58fbaeaecfa0bf02023-09-27T07:48:49ZengKorean Society of Ultrasound in MedicineUltrasonography2288-59192288-59432023-10-0142451853110.14366/usg.230551681Diagnostic performance of ultrasound risk stratification systems on thyroid nodules cytologically classified as indeterminate: a systematic review and meta-analysisZhichao Xing0Yuxuan Qiu1Jingqiang Zhu2Anping Su3Wenshuang Wu4 Center of Thyroid and Parathyroid Surgery, West China Hospital, Sichuan University, Chengdu, China Ultrasound Department, West China Hospital, Sichuan University, Chengdu, China Center of Thyroid and Parathyroid Surgery, West China Hospital, Sichuan University, Chengdu, China Center of Thyroid and Parathyroid Surgery, West China Hospital, Sichuan University, Chengdu, China Center of Thyroid and Parathyroid Surgery, West China Hospital, Sichuan University, Chengdu, ChinaPurpose Ultrasound (US) risk stratification systems (RSSs) are increasingly being utilized for the optimal management of thyroid nodules, including those with indeterminate cytology. The goal of this study was to evaluate the category-based diagnostic performance of US RSSs in identifying malignancy in indeterminate nodules. Methods This systematic review and meta-analysis was registered on PROSPERO (CRD42021266195). PubMed, EMBASE, and Web of Science were searched through December 1, 2022. Original articles reporting data on the performance of US RSSs for indeterminate nodules were included. The numbers of nodules classified as true negative, true positive, false negative, and false positive were extracted. Results Thirty-three studies evaluating 7,225 indeterminate thyroid nodules were included. The diagnostic accuracy was quantitatively synthesized using a Bayesian bivariate model based on the integrated nested Laplace approximation in R. For the intermediate- to high-risk category, the sensitivity levels of the American College of Radiology, the American Thyroid Association, the European Thyroid Association, the Korean Thyroid Association/Korean Society of Thyroid Radiology, and Kwak et al. were found to be 0.80, 0.72, 0.76, 0.96, and 0.97, respectively. The corresponding specificity measurements were 0.36, 0.50, 0.49, 0.28, and 0.17. Furthermore, for the high-risk category, the sensitivity values were 0.40, 0.46, 0.55, 0.47, and 0.10, while the specificity levels were 0.91, 0.90, 0.71, 0.91, and 0.99, respectively. Conclusion The overall diagnostic performance of the US RSSs was moderate in the differentiation of indeterminate nodules.http://www.e-ultrasonography.org/upload/usg-23055.pdfultrasonographythyroidbiopsydiagnosismeta-analysis |
| spellingShingle | Zhichao Xing Yuxuan Qiu Jingqiang Zhu Anping Su Wenshuang Wu Diagnostic performance of ultrasound risk stratification systems on thyroid nodules cytologically classified as indeterminate: a systematic review and meta-analysis Ultrasonography ultrasonography thyroid biopsy diagnosis meta-analysis |
| title | Diagnostic performance of ultrasound risk stratification systems on thyroid nodules cytologically classified as indeterminate: a systematic review and meta-analysis |
| title_full | Diagnostic performance of ultrasound risk stratification systems on thyroid nodules cytologically classified as indeterminate: a systematic review and meta-analysis |
| title_fullStr | Diagnostic performance of ultrasound risk stratification systems on thyroid nodules cytologically classified as indeterminate: a systematic review and meta-analysis |
| title_full_unstemmed | Diagnostic performance of ultrasound risk stratification systems on thyroid nodules cytologically classified as indeterminate: a systematic review and meta-analysis |
| title_short | Diagnostic performance of ultrasound risk stratification systems on thyroid nodules cytologically classified as indeterminate: a systematic review and meta-analysis |
| title_sort | diagnostic performance of ultrasound risk stratification systems on thyroid nodules cytologically classified as indeterminate a systematic review and meta analysis |
| topic | ultrasonography thyroid biopsy diagnosis meta-analysis |
| url | http://www.e-ultrasonography.org/upload/usg-23055.pdf |
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