Journal article
Performance of Five Ultrasound Risk Stratification Systems in Selecting Thyroid Nodules for FNA.
- Castellana M Department of Emergency and Organ Transplantation, Section of Internal Medicine, Endocrinology, Andrology and Metabolic Diseases, University of Bari Aldo Moro, Bari, Italy.
- Castellana C University of Bari Aldo Moro, Bari, Italy.
- Treglia G Clinic for Nuclear Medicine and Competence Center for Thyroid Diseases, Imaging Institute of Southern Switzerland, Ente Ospedaliero Cantonale, Bellinzona, Switzerland.
- Giorgino F Department of Emergency and Organ Transplantation, Section of Internal Medicine, Endocrinology, Andrology and Metabolic Diseases, University of Bari Aldo Moro, Bari, Italy.
- Giovanella L Clinic for Nuclear Medicine and Competence Center for Thyroid Diseases, Imaging Institute of Southern Switzerland, Ente Ospedaliero Cantonale, Bellinzona, Switzerland.
- Russ G Thyroid Imaging and Cytopathology Centre, Paris, France.
- Trimboli P Clinic for Nuclear Medicine and Competence Center for Thyroid Diseases, Imaging Institute of Southern Switzerland, Ente Ospedaliero Cantonale, Bellinzona, Switzerland.
- 2019-11-07
Published in:
- The Journal of clinical endocrinology and metabolism. - 2020
English
CONTEXT
Ultrasound (US) risk stratification systems (RSSs) have been developed to reduce the number of unnecessary fine-needle aspiration procedures (FNA) in patients with thyroid nodules.
OBJECTIVE
We conducted a systematic review and meta-analysis evaluating the ability of the 5 most common US RSSs for the appropriate selection of thyroid nodules for FNA.
DATA SOURCES
This systematic review and meta-analysis was registered on PROSPERO (CRD42019131771). PubMed, CENTRAL, Scopus, and Web of Science were searched until March 2019.
STUDY SELECTION
Original articles reporting data on the performance of AACE/ACE/AME, ACR TI-RADS, ATA, EU-TIRADS, and K-TIRADS were included.
DATA EXTRACTION
The number of nodules classified as true negative, true positive, false negative, and false positive was extracted. Summary operating points were estimated using a random-effects model. Interobserver agreement was also assessed.
DATA SYNTHESIS
Twelve studies evaluating 18 750 thyroid nodules were included. Participants were adult outpatients with thyroid nodules submitted to either FNA or core-needle biopsy or surgery and with available US images. The final diagnosis for malignant nodules was generally based on histology, while cytology was used for benign nodules. Diagnostic odds ratio (DOR) ranged from 2.2 to 4.9. A head-to-head comparison showed a higher relative DOR for ACR-TIRADS versus ATA (P = .002) or K-TIRADS (P = .002), due to a higher relative likelihood ratio for positive results.
CONCLUSIONS
The present meta-analysis found a higher performance of ACR TI-RADS in selecting thyroid nodules for FNA. However, the comparison across the most common US RSSs was limited by the data available. Further studies are needed to confirm this finding.
Ultrasound (US) risk stratification systems (RSSs) have been developed to reduce the number of unnecessary fine-needle aspiration procedures (FNA) in patients with thyroid nodules.
OBJECTIVE
We conducted a systematic review and meta-analysis evaluating the ability of the 5 most common US RSSs for the appropriate selection of thyroid nodules for FNA.
DATA SOURCES
This systematic review and meta-analysis was registered on PROSPERO (CRD42019131771). PubMed, CENTRAL, Scopus, and Web of Science were searched until March 2019.
STUDY SELECTION
Original articles reporting data on the performance of AACE/ACE/AME, ACR TI-RADS, ATA, EU-TIRADS, and K-TIRADS were included.
DATA EXTRACTION
The number of nodules classified as true negative, true positive, false negative, and false positive was extracted. Summary operating points were estimated using a random-effects model. Interobserver agreement was also assessed.
DATA SYNTHESIS
Twelve studies evaluating 18 750 thyroid nodules were included. Participants were adult outpatients with thyroid nodules submitted to either FNA or core-needle biopsy or surgery and with available US images. The final diagnosis for malignant nodules was generally based on histology, while cytology was used for benign nodules. Diagnostic odds ratio (DOR) ranged from 2.2 to 4.9. A head-to-head comparison showed a higher relative DOR for ACR-TIRADS versus ATA (P = .002) or K-TIRADS (P = .002), due to a higher relative likelihood ratio for positive results.
CONCLUSIONS
The present meta-analysis found a higher performance of ACR TI-RADS in selecting thyroid nodules for FNA. However, the comparison across the most common US RSSs was limited by the data available. Further studies are needed to confirm this finding.
- Language
-
- English
- Open access status
- closed
- Identifiers
-
- DOI 10.1210/clinem/dgz170
- PMID 31690937
- Persistent URL
- https://folia.unifr.ch/global/documents/54238
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