TY - JOUR
T1 - Diagnostic accuracy of ultrasound-guided fine needle aspiration biopsy for thyroid malignancy
T2 - systematic review and meta-analysis
AU - Singh Ospina, Naykky
AU - Brito, Juan P.
AU - Maraka, Spyridoula
AU - Espinosa de Ycaza, Ana E.
AU - Rodriguez-Gutierrez, Rene
AU - Gionfriddo, Michael R.
AU - Castaneda-Guarderas, Ana
AU - Benkhadra, Khalid
AU - Al Nofal, Alaa
AU - Erwin, Patricia
AU - Morris, John C.
AU - Castro, M. Regina
AU - Montori, Victor M.
N1 - Publisher Copyright:
© 2016, Springer Science+Business Media New York.
PY - 2016/9/1
Y1 - 2016/9/1
N2 - 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.
AB - 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.
KW - Diagnosis
KW - Thyroid cancer
KW - Thyroid nodule
KW - Ultrasound-guided fine needle aspiration biopsy
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U2 - 10.1007/s12020-016-0921-x
DO - 10.1007/s12020-016-0921-x
M3 - Article
C2 - 27071659
AN - SCOPUS:84963636162
VL - 53
SP - 651
EP - 661
JO - Endocrine
JF - Endocrine
SN - 1355-008X
IS - 3
ER -