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Substernal Thyroid Biopsy Using Endobronchial Ultrasound-guided Transbronchial Needle Aspiration
Published on: November 10, 2014
Pediatric thyroid fine-needle aspiration cytology: a meta-analysis
Christopher Stevens1, Justin K P Lee, Mohsen Sadatsafavi
1Division of Pediatric General Surgery, University of British Columbia, Vancouver, British Columbia, Canada.
Journal of Pediatric Surgery
|December 1, 2009
Summary
Fine-needle aspiration (FNA) biopsy is a sensitive tool for diagnosing pediatric thyroid nodules, with high accuracy in excluding malignancy. This meta-analysis confirms its utility in differentiating benign from malignant tumors in children.
Area of Science:
- Pediatric Endocrinology
- Oncology
- Diagnostic Accuracy
Background:
- Conflicting evidence exists regarding the diagnostic utility of fine-needle aspiration (FNA) biopsy for pediatric thyroid nodules.
- Previous studies show variable sensitivity and specificity, necessitating a comprehensive review.
Purpose of the Study:
- To investigate the diagnostic parameters of FNA biopsy in pediatric thyroid nodules.
- To determine the sensitivity, specificity, accuracy, positive predictive value (PPV), and negative predictive value (NPV) for differentiating malignant from benign thyroid tumors in children.
Main Methods:
- A systematic literature search was conducted across Medline, Embase, and EBM reviews for relevant English-language studies.
- Two independent reviewers selected studies, extracted diagnostic values, and performed a meta-analysis using a random-effects, bivariate meta-regression model.
- Study quality was assessed using the Quality Assessment for Diagnostic Accuracy Studies (QUADAS) tool.
Main Results:
- Twelve studies met the inclusion criteria, generally demonstrating good quality.
- The pooled sensitivity was 94% (95% CI, 86%-100%) and pooled specificity was 81% (95% CI, 72%-91%).
- With an assumed malignancy prevalence of 20%, the accuracy was 83.6%, PPV was 55.3%, and NPV was 98.2%.
Conclusions:
- Fine-needle aspiration biopsy is a highly sensitive diagnostic test for pediatric thyroid nodules.
- FNA biopsy is a valuable tool for effectively excluding malignancy in pediatric patients with thyroid nodules.
- Further prospective research is recommended to validate these findings.
