Diagnostic accuracy of ultrasound-guided fine needle aspiration biopsy for thyroid malignancy: systematic review and meta-analysis

Naykky Singh Ospina, Juan Brito Campana, Spyridoula Maraka, Ana E. Espinosa de Ycaza, Rene Rodriguez-Gutierrez, Michael R. Gionfriddo, Ana Castaneda-Guarderas, Khalid Benkhadra, Alaa Al Nofal, Patricia Erwin, John C. Morris, M. Regina Castro, Victor Manuel Montori

Research output: Contribution to journalArticlepeer-review

24 Scopus citations

Abstract

Purpose: To systematically appraise and summarize the available evidence about the diagnostic accuracy of ultrasound-guided fine needle aspiration biopsy (USFNA) for thyroid malignancy, and to explore the integration of these estimates with the probability of thyroid malignancy before USFNA. Methods: A comprehensive search of multiple databases from each database’s inception to August 2014 was performed. Eligible studies included those that evaluated patients with thyroid nodules who underwent USFNA and subsequent evaluation by histopathology or long-term follow-up. Results: We identified 32 studies at moderate risk of bias evaluating the USFNA diagnostic characteristics for the diagnosis of thyroid malignancy. Results were imprecise and inconsistent across trials. The pooled likelihood ratio (LR) of thyroid malignancy for a benign USFNA result was 0.09 (95 % CI 0.06, 0.14; I2 = 33 %), whereas the pooled LR for a malignant result was 197 (95 % CI, 68, 569; I2 = 77 %). In the case of a suspicious for follicular neoplasm result, the pooled LR for malignancy was 0.6 (95 % CI, 0.4, 1.0; I2 = 84 %) and 8.3 (95 % CI, 3.6, 19.2; I2 = 89) for a result of suspicious for malignancy. Conclusion: The available evidence regarding the diagnostic accuracy of USFNA warrants only limited confidence due to risk of bias, imprecision, and inconsistency. However, some USFNA results (benign, malignant) are likely very helpful, by significantly changing the pre-test probability of thyroid cancer.

Original languageEnglish (US)
Pages (from-to)1-11
Number of pages11
JournalEndocrine
DOIs
StateAccepted/In press - Apr 12 2016

Keywords

  • Diagnosis
  • Thyroid cancer
  • Thyroid nodule
  • Ultrasound-guided fine needle aspiration biopsy

ASJC Scopus subject areas

  • Endocrinology
  • Endocrinology, Diabetes and Metabolism

Fingerprint Dive into the research topics of 'Diagnostic accuracy of ultrasound-guided fine needle aspiration biopsy for thyroid malignancy: systematic review and meta-analysis'. Together they form a unique fingerprint.

Cite this