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

Area of Science:

• Radiology
• Oncology
• Medical Imaging

Background:

• Superb microvascular imaging (SMI) has shown potential in detecting tumor angiogenesis for thyroid nodule differentiation.
• No prior systematic reviews have comprehensively evaluated the diagnostic accuracy of SMI for thyroid nodules.

Purpose of the Study:

• To systematically review and meta-analyze the accuracy of ultrasound-based superb microvascular imaging (SMI) in diagnosing thyroid nodules.
• To determine the overall diagnostic performance of SMI in differentiating between benign and malignant thyroid nodules.

Main Methods:

• A comprehensive literature search was conducted across PubMed, Cochrane Library, and CBM databases.
• Meta-analysis was performed using STATA 14.0 and Meta-Disc 1.4, calculating sensitivity, specificity, likelihood ratios, and diagnostic odds ratio.
• Data were pooled using fixed-effects or random-effects models based on heterogeneity assessment, including construction of a synthetic receiver operating characteristic curve.

Main Results:

• Eleven studies with 1003 malignant and 957 benign nodules were included.
• Pooled sensitivity was 0.81 (95% CI: 0.79-0.84) and pooled specificity was 0.86 (95% CI: 0.84-0.88).
• The area under the synthetic ROC curve was 0.89 (95% CI: 0.86-0.91), indicating high diagnostic performance. No publication bias was detected.

Conclusions:

• Ultrasound superb microvascular imaging (SMI) demonstrates high diagnostic accuracy for differentiating benign and malignant thyroid nodules.
• SMI is a promising tool for improving the diagnostic workup of thyroid nodules.