Real-Time Elastography for the Differentiation of Benign and Malignant Thyroid Nodules: A Meta-Analysis.
Summary of "Real-Time Elastography for the Differentiation of Benign and Malignant Thyroid Nodules: A Meta-Analysis."
Background: Work-up of thyroid nodules remains challenging. Fine-needle aspiration (FNA) has been shown to be the most cost-effective way to select patients for surgery with sensitivities of 54%-90% and specificities of 60%-96% for the detection of malignant lesions. Ultrasound-based real-time elastography (RTE) enables the determination of tissue elasticity and has shown promising results for the differentiation of thyroid nodules. A meta-analysis was performed to assess the overall performance of RTE for the differentiation of thyroid nodules. Methods: Literature databases were searched. The inclusion criteria for studies were the use of FNA cytology histopathology of surgical specimens as the diagnostic reference standard and assessment of sensitivity and specificity of RTE. The meta-analysis was performed using an inverse variance method and the Der Simonian and Laird Random effect estimator in case of established heterogeneity. Results: Eight studies that included a total of 639 thyroid nodules were analyzed. The overall mean sensitivity and specificity for the diagnosis of malignant thyroid nodules by RTE of the eight studies was 92% confidence interval 88-96 and 90% confidence interval 85-95, respectively. A significant heterogeneity was found for specificity of the different studies. Conclusions: RTE has a high sensitivity and specificity in the evaluation of thyroid nodules. This technique might be useful in conjunction or even instead of FNA to select patients with thyroid nodules for surgery.
Affiliation
1 Department of Internal Medicine I, J.W. Goethe-University Hospital , Frankfurt, Germany .
Journal Details
This article was published in the following journal.
Name: Thyroid : official journal of the American Thyroid Association
ISSN: 1557-9077
Pages:
Links
- PubMed Source: http://www.ncbi.nlm.nih.gov/pubmed/20860422
- DOI: http://dx.doi.org/10.1089/thy.2010.0079
Medical and Biotech [MESH] Definitions
Thyroid Nodule
A small circumscribed mass in the THYROID GLAND that can be of neoplastic growth or non-neoplastic abnormality. It lacks a well-defined capsule or glandular architecture. Thyroid nodules are often benign but can be malignant. The growth of nodules can lead to a multinodular goiter (GOITER, NODULAR).
Goiter, Nodular
An enlarged THYROID GLAND containing multiple nodules (THYROID NODULE), usually resulting from recurrent thyroid HYPERPLASIA and involution over many years to produce the irregular enlargement. Multinodular goiters may be nontoxic or may induce THYROTOXICOSIS.
Ultrasonography, Doppler, Duplex
Ultrasonography applying the Doppler effect combined with real-time imaging. The real-time image is created by rapid movement of the ultrasound beam. A powerful advantage of this technique is the ability to estimate the velocity of flow from the Doppler shift frequency.
Pseudolymphoma
A group of disorders having a benign course but exhibiting clinical and histological features suggestive of malignant lymphoma. Pseudolymphoma is characterized by a benign infiltration of lymphoid cells or histiocytes which microscopically resembles a malignant lymphoma. (From Dorland, 28th ed & Stedman, 26th ed)
Multiple Pulmonary Nodules
A number of small lung lesions characterized by small round masses of 2- to 3-mm in diameter. They are usually detected by chest CT scans (COMPUTED TOMOGRAPHY, X-RAY). Such nodules can be associated with metastases of malignancies inside or outside the lung, benign granulomas, or other lesions.
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