The role of elastography in evaluating thyroid nodules: a literature review and meta-analysis

To appraise the literature for studies involving the use of elastography to diagnose thyroid nodule pathology. Two independent reviewers performed a systematic review of the English medical literature for studies involving elastography diagnosing thyroid nodule pathology. Data gleaned from this process was used in a meta-analysis to summarise the results. Thirty-eight studies were used in the meta-analysis totalling 5,942 thyroid nodules examined with elastography. The pooled results were sensitivity = 87.0 % (95 % confidence intervals (CI) = 86.2-87.9 %), specificity = 80.6 % (CI = 79.5-81.6 %), positive predictive value (PPV) = 48.9 % (CI = 47.6-50.2 %), negative predictive value (NPV) = 96.7 % (CI = 96.2-97.1 %), diagnostic accuracy = 81.7 % (CI = 80.7-82.7 %). Subgroup analysis of the data is also presented. Elastography has its limitations in the diagnosis of thyroid nodules; however, its high NPV is increasingly being used as an important investigation and may allow a reduction in the number of hemi-thyroidectomies with benign pathology. Subgroup analysis suggests that elastography techniques where compressive force is performed in a non-user-dependant method results in improved final results.