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Li J, Zhang YR, Ren JY, Li QL, Zhu PS, Du TT, Ge XY, Chen M, Cui XW. Association between diagnostic efficacy of acoustic radiation force impulse for benign and malignant thyroid nodules and the presence or absence of non-papillary thyroid cancer: A meta-analysis. Front Oncol 2023; 13:1007464. [PMID: 36776305 PMCID: PMC9915625 DOI: 10.3389/fonc.2023.1007464] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2022] [Accepted: 01/09/2023] [Indexed: 01/30/2023] Open
Abstract
Purpose The aim of this study was to investigate the diagnostic efficacy of Acoustic Radiation Force Impulse (ARFI) for benign and malignant thyroid nodules in the presence and absence of non-papillary thyroid cancer (NPTC) and to determine the cut-off values of Shear Wave Velocity (SWV) for the highest diagnostic efficacy of Virtual Touch Quantification (VTQ) and Virtual Touch Tissue Imaging and Quantification (VTIQ). Methods The diagnostic accuracy of ARFI for benign and malignant thyroid nodules was assessed by pooling sensitivity, specificity and area under the curve (AUC) in each group in the presence and absence of both non-papillary thyroid glands, using histology and cytology as the gold standard. All included studies were divided into two groups according to VTQ and VTIQ, and each group was ranked according to the magnitude of the SWV cutoff value to determine the SWV cutoff interval with the highest diagnostic efficacy for VTQ and VTIQ. Results A total of 57 studies were collected on the evaluation of ARFI for the diagnosis of benign and malignant thyroid nodules. The results showed that the presence of non-papillary thyroid carcinoma led to differences in the specificity of VTIQ for the identification of benign and malignant thyroid nodules, and the differences were statistically significant. In addition, the diagnostic efficacy of VTQ was best when the cutoff value of SWV was in the interval of 2.48-2.55 m/s, and the diagnostic efficacy of VTIQ was best when the cutoff value of SWV was in the interval of 3.01-3.15 m/s. Conclusion VTQ and VTIQ have a high diagnostic value for benign and malignant thyroid nodules; however, when the malignant nodules in the study contain non-papillary thyroid carcinoma occupying the thyroid gland, the findings should be viewed in a comprehensive manner.
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Affiliation(s)
- Jun Li
- Department of Ultrasound, First Affiliated Hospital, School of Medicine, Shihezi University, Shihezi, China,*Correspondence: Jun Li, ; Xin Wu Cui,
| | - Yu-Rui Zhang
- Department of Ultrasound, First Affiliated Hospital, School of Medicine, Shihezi University, Shihezi, China
| | - Jia-Yu Ren
- Department of Medical Ultrasound, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Qiao-Li Li
- Department of Ultrasound, First Affiliated Hospital, School of Medicine, Shihezi University, Shihezi, China
| | - Pei-Shan Zhu
- Department of Ultrasound, First Affiliated Hospital, School of Medicine, Shihezi University, Shihezi, China
| | - Ting-Ting Du
- Department of Ultrasound, First Affiliated Hospital, School of Medicine, Shihezi University, Shihezi, China
| | - Xiao-Yan Ge
- Department of Ultrasound, First Affiliated Hospital, School of Medicine, Shihezi University, Shihezi, China
| | - Ming Chen
- Department of Ultrasound, First Affiliated Hospital, School of Medicine, Shihezi University, Shihezi, China
| | - Xin Wu Cui
- Department of Medical Ultrasound, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China,*Correspondence: Jun Li, ; Xin Wu Cui,
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Cantisani V, De Silvestri A, Scotti V, Fresilli D, Tarsitano MG, Polti G, Guiban O, Polito E, Pacini P, Durante C, Grani G, Isidori AM, Giannetta E, Sorrenti S, Trimboli P, Catalano C, Cirocchi R, Lauro A, D'Andrea V. US-Elastography With Different Techniques for Thyroid Nodule Characterization: Systematic Review and Meta-analysis. Front Oncol 2022; 12:845549. [PMID: 35371974 PMCID: PMC8966910 DOI: 10.3389/fonc.2022.845549] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2021] [Accepted: 02/16/2022] [Indexed: 12/25/2022] Open
Abstract
Background Thyroid nodules are frequent in adult population and thyroid cancer incidence has increased dramatically over the past three decades. The aim of this systematic review and meta-analysis was to evaluate the US-Elastosonography (USE) diagnostic performance in assessing the thyroid nodules malignancy risk. Methods PubMed and Embase databases were searched from January 2011 to July 2021. We extracted data from selected studies and calculated the overall diagnostic accuracy of qualitative USE, semi-quantitative USE and quantitative USE. Summary receiver operating characteristic (ROC) curve was elaborated to show the results. All statistical tests were performed using Metadisc and Medcal software package. Results Finally 72 studies with 13,505 patients and 14,015 thyroid nodules (33% malignant) undergoing elastography were included. The pooled sensitivity, specificity and AUC were 84%, 81%, and 0.89 respectively for qualitative USE; 83%, 80%, and 0.93 for semi-quantitative USE and 78%, 81% and 0.87, for quantitative USE. The qualitative and semiquantitative USE present very similar diagnostic accuracy values and both better than the quantitative USE. Conclusions USE is a useful imaging tool for thyroid nodule characterization. In accordance with recent guidelines and meta-analyses, the USE could be used daily in thyroid nodule malignancy risk stratification. Systematic Review Registration PROSPERO: CRD42021279257.
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Affiliation(s)
- Vito Cantisani
- Department of Radiological Sciences, Oncology and Pathology, Policlinico Umberto I, Sapienza University of Rome, Rome, Italy
| | - Annalisa De Silvestri
- Servizio di Epidemiologia Clinica e Biometria Direzione Scientifica-Fondazione Istituti di Ricovero e Cura a Carattere Scientifico (IRCCS) Policlinico san Matteo, Pavia, Italy
| | - Valeria Scotti
- Servizio di Epidemiologia Clinica e Biometria Direzione Scientifica-Fondazione Istituti di Ricovero e Cura a Carattere Scientifico (IRCCS) Policlinico san Matteo, Pavia, Italy
| | - Daniele Fresilli
- Department of Radiological Sciences, Oncology and Pathology, Policlinico Umberto I, Sapienza University of Rome, Rome, Italy
| | - Maria Grazia Tarsitano
- Department of Clinical and Surgical Science, "Magna Graecia" University, Catanzaro, Italy
| | - Giorgia Polti
- Department of Radiological Sciences, Oncology and Pathology, Policlinico Umberto I, Sapienza University of Rome, Rome, Italy
| | - Olga Guiban
- Department of Radiological Sciences, Oncology and Pathology, Policlinico Umberto I, Sapienza University of Rome, Rome, Italy
| | - Eleonora Polito
- Department of Radiological Sciences, Oncology and Pathology, Policlinico Umberto I, Sapienza University of Rome, Rome, Italy
| | - Patrizia Pacini
- Department of Radiological Sciences, Oncology and Pathology, Policlinico Umberto I, Sapienza University of Rome, Rome, Italy
| | - Cosimo Durante
- Department of Translational and Precision Medicine, "Sapienza" University of Rome, Rome, Italy
| | - Giorgio Grani
- Department of Translational and Precision Medicine, "Sapienza" University of Rome, Rome, Italy
| | - Andrea M Isidori
- Department of Experimental Medicine, Sapienza University of Rome, Rome, Italy
| | - Elisa Giannetta
- Department of Experimental Medicine, Sapienza University of Rome, Rome, Italy
| | - Salvatore Sorrenti
- Department of Surgical Sciences, Hospital "Policlinico Umberto I", "Sapienza" University of Rome, Rome, Italy
| | - Pierpaolo Trimboli
- Clinic for Endocrinology and Diabetology, Lugano Regional Hospital, Ente Ospedaliero Cantonale, Lugano, Switzerland
| | - Carlo Catalano
- Department of Radiological Sciences, Oncology and Pathology, Policlinico Umberto I, Sapienza University of Rome, Rome, Italy
| | - Roberto Cirocchi
- Department of Surgery and Biomedical Sciences, University of Perugia, Perugia, Italy
| | - Augusto Lauro
- Department of Surgical Sciences, Hospital "Policlinico Umberto I", "Sapienza" University of Rome, Rome, Italy
| | - Vito D'Andrea
- Department of Surgical Sciences, Hospital "Policlinico Umberto I", "Sapienza" University of Rome, Rome, Italy
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Filho RHC, Pereira FL, Iared W. Diagnostic Accuracy Evaluation of Two-Dimensional Shear Wave Elastography in the Differentiation Between Benign and Malignant Thyroid Nodules: Systematic Review and Meta-analysis. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2020; 39:1729-1741. [PMID: 32227500 DOI: 10.1002/jum.15271] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/18/2019] [Revised: 02/11/2020] [Accepted: 02/29/2020] [Indexed: 06/10/2023]
Abstract
OBJECTIVES To evaluate two-dimensional (2D) shear wave elastography (SWE) performance as an independent predictor of malignancy in the diagnostic differentiation of thyroid nodules (TNs), including subgroup analyses of different manufacturers and respective cutoffs points. METHODS The online databases MEDLINE (PubMed), Embase, and the Cochrane Library were searched for articles using 2D SWE in TN evaluation. After good-quality relevant thyroid-specific articles were selected, the main data, plus their sensitivity and specificity, were tabulated. Summary receiver operating characteristic curves were generated to verify the accuracy of data obtained from 3 manufactures. A meta-analysis was performed to evaluate whether clinical recommendations can be improved by the use of 2D SWE to differentiate TNs. RESULTS The sensitivity and specificity parameters of 2D SWE for the differentiation between benign and malignant TNs according to different instruments were, respectively, as follows: Toshiba SWE (Toshiba Medical Systems, Tochigi, Japan), 0.77 (95% confidence interval [CI], 0.70-0.83) and 0.76 (95% CI, 0.72-0.81); Virtual Touch tissue imaging and quantification (Siemens Medical Solutions, Mountain View, CA), 0.72 (95% CI, 0.67-0.77) and 0.81 (95% CI, 0.78-0.84); and SuperSonic SWE (SuperSonic Imagine, Aix-en-Provence, France), 0.63 (95% CI, 0.59-0.66) and 0.81 (95% CI, 0.79-0.83). The summary receiver operating characteristic curves showed the following area under the curve syntheses: Toshiba SWE, 0.84 (Q* = 0.7707); Virtual Touch tissue imaging and quantification, 0.85 (Q* = 0.7809); and SuperSonic SWE, 0.88 (Q* = 0.8102). Positive and negative predictive values varied, respectively, from 16% to 94% and 29% to 100%, considering all included articles. The overall accuracy ranged from 53% to 93%. CONCLUSIONS Two-dimensional SWE is a relevant and an important tool that supports ultrasound in clinical practice in the diagnostic differentiation between benign and malignant TNs.
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Affiliation(s)
| | | | - Wagner Iared
- Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, Brazil
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Huang R, Jiang L, Xu Y, Gong Y, Ran H, Wang Z, Sun Y. Comparative Diagnostic Accuracy of Contrast-Enhanced Ultrasound and Shear Wave Elastography in Differentiating Benign and Malignant Lesions: A Network Meta-Analysis. Front Oncol 2019; 9:102. [PMID: 30891425 PMCID: PMC6412152 DOI: 10.3389/fonc.2019.00102] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2018] [Accepted: 02/04/2019] [Indexed: 12/12/2022] Open
Abstract
Background: We performed a network meta-analysis to compare the diagnostic accuracy of contrast-enhanced ultrasound (CEUS) and shear wave elastography (SWE) in differentiating benign and malignant lesions in different body sites. Methods: A computerized literature search of Medline, Embase, SCOPUS, and Web of Science was performed using relevant keywords. Following data extraction, we calculated sensitivity, specificity, positive likelihood ratio (LR), negative LR, and diagnostic odds ratio (DOR) for CEUS, and SWE compared to histopathology as a reference standard. Statistical analyses were conducted by MetaDiSc (version 1.4) and R software (version 3.4.3). Results: One hundred and fourteen studies (15,926 patients) were pooled in the final analyses. Network meta-analysis showed that CEUS had significantly higher DOR than SWE (DOR = 27.14, 95%CI [2.30, 51.97]) in breast cancer detection. However, there were no significant differences between CEUS and SWE in hepatic (DOR = −6.67, 95%CI [−15.08, 1.74]) and thyroid cancer detection (DOR = 3.79, 95%CI [−3.10, 10.68]). Interestingly, ranking analysis showed that CEUS achieved higher DOR in detecting breast and thyroid cancer, while SWE achieved higher DOR in detecting hepatic cancer. The overall DOR for CEUS in detecting renal cancer was 53.44, 95%CI [29.89, 95.56] with an AUROC of 0.95, while the overall DOR for SWE in detecting prostate cancer was 25.35, 95%CI [7.15, 89.89] with an AUROC of 0.89. Conclusion: Both diagnostic tests showed relatively high sensitivity and specificity in detecting malignant tumors in different organs. Network meta-analysis showed that CEUS had higher diagnostic accuracy than SWE in detecting breast and thyroid cancer, while SWE had higher accuracy in detecting hepatic cancer. However, the results were not statistically significant in hepatic and thyroid malignancies. Further head-to-head comparisons are needed to confirm the optimal imaging technique to differentiate each cancer type.
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Affiliation(s)
- Rongzhong Huang
- The First People's Hospital of Yunnan Province, Kunming, China
| | - Lihong Jiang
- The First People's Hospital of Yunnan Province, Kunming, China
| | - Yu Xu
- Chuangxu Institute of Life Science, Chongqing, China
| | - Yuping Gong
- Second Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Haitao Ran
- Second Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Zhigang Wang
- Second Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Yang Sun
- Second Affiliated Hospital of Chongqing Medical University, Chongqing, China
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