Int J Thyroidol.  2018 May;11(1):31-40. 10.11106/ijt.2018.11.1.31.

Diagnostic Performance of Shear Wave Elastography as Add-on Test in Thyroid Nodules: a Systematic Review and Meta-Analysis

• Park SY
• Song JY
• Lee MJ
• Lee KM
• Jeon MH
• Ko RJ
• Kim SH
• Kang BJ

• KMID: 2428069
• DOI: http://doi.org/10.11106/ijt.2018.11.1.31

Abstract

BACKGROUND AND OBJECTIVES
The diagnostic performance of shear wave elastography (SWE) combined with ultrasound (US) in the differential diagnosis of thyroid nodules was evaluated.
MATERIALS AND METHODS
459 articles were collected using KoreaMed, Ovid-MEDLINE, Ovid-EMBASE, and Cochrane Library. The searching words were "˜{(elastography and shear).mp. OR SWE.mp. OR acoustic radiation force impulse.mp. OR ARFI.mp. OR acuson.mp. OR aixplorer.mp.}'. Two authors independently performed article selection and evaluation of the quality of studies with Scottish Intercollegiate Guidelines Network tool.
RESULTS
2582 specimens (thyroid nodules) from 11 studies selected were included in this review. Combined use of US and SWE was reported higher specificity in five literatures, lower specificity in five studies, and no changes in 1 study when compared to US. We performed meta-analysis using data from 10 studies. The pooled sensitivity and specificity of US and SWE group for the differential diagnosis of benign and malignant nodules were 0.91 (I2=83.4%), 0.73 (I2=95.9%). The pooled sensitivity and specificity of US alone group were 0.88 (I2=93.2%), 0.71 (I2=92.7%).
CONCLUSION
SWE is not effective in the differential diagnosis of thyroid nodules to minimize unnecessary biopsy of nodules. The included studies showed significant heterogeneity of results.

Keyword

Thyroid nodule; Shear wave elastography; Diagnostic performance; Effectiveness

MeSH Terms

Acoustics
Biopsy
Diagnosis, Differential
Elasticity Imaging Techniques*
Population Characteristics
Sensitivity and Specificity
Thyroid Gland*
Thyroid Nodule*
Ultrasonography

Figure

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  Fig. 1. Literature search flow diagram. SWE: shear wave elastography, US: ultrasonography.

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  Fig. 2. Forest plot of sensitivities for SWE＋ US and US. CI: confidential interval, NA: not available, SWE: shear wave elastography, US: ultrasonography, VTI: virtual touch tissue imaging, VTQ: virtual touch tissue quantification

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  Fig. 3. Forest plot of specificities for SWE＋ US and US. CI: confidential interval, NA: not available, SWE: shear wave elastography, US: ultrasonography, VTI: virtual touch tissue imaging, VTQ: virtual touch tissue quantification

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