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Diagnostic Performance of Shear Wave Elastography as Add-on Test in Thyroid Nodules: a Systematic Review and Meta-Analysis
Int J Thyroidol 2018;11(1):31-40
Published online May 30, 2018;  https://doi.org/10.11106/ijt.2018.11.1.31
© 2018 Korean Thyroid Association.

Sun-young Park1, Ji Yang Song1, Min Jin Lee1, Kyung Min Lee1, Mi Hye Jeon1, Ryeo Jin Ko1, Seok-Hyun Kim1 and Bong Joo Kang2

Division of New Health Technology Assessment, National Evidence-based Healthcare Collaborating Agency1, Department of Radiology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea2, Seoul, Korea
Correspondence to: Bong Joo Kang, MD, PhD, Department of Radiology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, 222 Banpo-daero, Seocho-gu, Seoul 06591, Korea
Tel: 82-2-2258-6253, Fax: 82-2-599-6771, E-mail: lionmain@catholic.ac.kr
Seok-Hyun Kim, MD, PhD, Division of New Health Technology Assessment, National Evidence-based Healthcare Collaborating Agency, Namsan Square (Kukdong B/D) 7F, Toegye-ro, Jung-gu, Seoul 04554, Korea
Tel: 82-2-2174-2850, Fax: 82-2-747-4916, E-mail: shkim@neca.re.kr
Received November 24, 2017; Revised January 31, 2018; Accepted February 1, 2018.
This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0), which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
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.
Keywords : Thyroid nodule, Shear wave elastography, Diagnostic performance, Effectiveness