Superb microvascular imaging for distinguishing thyroid nodules: A meta-analysis (PRISMA)

Medicine (Baltimore). 2022 Jun 17;101(24):e29505. doi: 10.1097/MD.0000000000029505.

Abstract

Background: Earlier studies have shown that the superb microvascular imaging (SMI) can detect tumor angiogenesis to distinguish thyroid nodules, but there is no systematic review. This meta-analysis aimed to identify the accuracy of ultrasound SMI for the diagnosis of thyroid nodules.

Methods: We searched PubMed, Cochrane Library, and CBM databases. A meta-analysis was conducted using STATA version 14.0 and Meta-Disc version 1.4 software. We calculated the summary statistics for sensitivity, specificity, positive and negative likelihood ratio (LR+/LR-), diagnostic odds ratio, and the synthetic receiver operating characteristic curve. Data will be pooled by either a fixed-effects model or a random-effects model according to the results of heterogeneity identification.

Results: 11 studies that met the inclusion criteria were included in this meta-analysis. The quality assessment of the study of diagnostic accuracy studies scores of all included studies were ≥22. A total of 1003 thyroid malignant nodules and 957 thyroid benign nodules were assessed. The main outcome included: the pooled sensitivity was 0.81 (95% confidence intervals (CI) = 0.79-0.84), and the pooled specificity was 0.86 (95% CI = 0.84-0.88); the pooled LR+ was 5.79 (95% CI = 4.44-7.54), and the pooled negative LR- was 0.23 (95% CI = 0.20-0.26); the pooled diagnostic odds ratio of SMI in the diagnosis of thyroid nodules was 26.84 (95% CI = 19.13-37.60). The area under the synthetic receiver operating characteristic curve was 0.89 (95% CI = 0.86-0.91). We found no evidence for publication bias (t = 0.72, P = .49).

Conclusion: Our meta-analysis indicates that SMI may have high diagnostic accuracy in distinguishing benign and malignant thyroid nodules.

Systematic review registration: INPLASY202080084.

Publication types

  • Meta-Analysis
  • Systematic Review

MeSH terms

  • Diagnosis, Differential
  • Humans
  • Odds Ratio
  • ROC Curve
  • Sensitivity and Specificity
  • Thyroid Nodule* / diagnostic imaging
  • Thyroid Nodule* / pathology
  • Ultrasonography / methods