Endocrine Abstracts

Background: Work-up of thyroid nodules remains challenging. Fine needle aspiration (FNA) has been shown to be the most cost–effective way to select patients for surgery with sensitivities of 54–69% and specificities of 60–96% for the detection of malignant lesions. Ultrasound-based Realtime Elastography (RTE) enables the determination of tissue elasticity and has shown promising results for the differentiation of thyroid nodules. A meta-analysis was performed to assess the overall performance of RTE for the differentiation of thyroid nodules.

Methods: Literature databases were searched. Inclusion criteria were: evaluation of RTE, cytology (FNA) or histology (surgery) as reference method, assessment of sensitivity and specificity of RTE. The meta-analysis was performed using the DerSimonian and Laird Random Effect estimator was used to combine results between the selected studies.

Results: Eight studies with overall 639 thyroid nodules were included in the analysis. Mean sensitivity and specificity for the diagnosis of malignant thyroid nodules were 92% (CI (88; 96), and 96% (CI (94; 97)), respectively (s. Figure). A significant heterogeneity was found for specificity of the different studies.

Discussion: RTE can be used with high sensitivity and specificity in the work-up of thyroid nodules and might be a useful method in addition to or even instead of FNA to select patients for surgery.