Table 1.
The main studies evaluating the diagnostic performance of elastography in differentiating benign and malignant thyroid nodules
| Study | No. of studies/centers | No. of nodules/patients | Type of design | Malignant proportion (%) | Type | Cut-offs | Sensitivity (%) | Specificity (%) | AUROC (%) |
|---|---|---|---|---|---|---|---|---|---|
| Moon et al. [36], 2012 | 1 | 703/676 | Retrospective | 30.8 | ES | Score 3-4 | 15.7 | 95.3 | - |
| Score 2-3 | 65.4 | 58.2 | - | ||||||
| Unluturk et al. [40], 2012 | 1 | 237/194 | Prospective | 25 | ES | Score 2-3 | 47 | 80 | 72 |
| SR | > 2.1 | 69 | 67 | 72 | |||||
| Ghajarzadeh et al. [41], 2014 | 12 | 1,180 | Meta-analysis | 30.8 | ES | Score 2-3 | 86 | 66.7 | 87.7 |
| Razavi et al. [38], 2013 | 24 | 3,531/2,624 | Meta-analysis | 32.8 | ES | - | 82 | 82 | 89 |
| 33.2 | SR | - | 89 | 82 | 93 | ||||
| Sun et al. [35], 2014 | 31 | 5,481/4,468 | Meta-analysis | 5.0-63.0 | ES | - | 79 | 77 | 89 |
| 1,063/983 | SR | - | 85 | 80 | 93 | ||||
| Friedrich-Rust et al. [33], 2016 | 7 | 657/602 | Prospective, multicenter | 13.7 | ES | Score 2-3 | 69 | 75 | - |
| SR | ≥2.66 | 58 | 78 | - | |||||
| Bojunga et al. [22], 2012 | 1 | 158/138 | - | 13.3 | pSWE | ≥2.57 m/sec | 57 | 85 | 69 |
| Liu et al. [32], 2015 | 13 | 1,854/1,641 | Meta-analysis | 13.3-45.1 | pSWE | ≥2.01-2.91 m/s | 81 | 84 | 91 |
| Dong et al. [42], 2015 | 13 | 1,617/1,451 | Meta-analysis | 30.6 | pSWE | - | 86 | 90 | 94 |
| Xu et al. [19], 2014 | 1 | 183/159 | Prospective | 36.1 | pSWE | ≥2.87 m/sec | 71.6 | 83.4 | 86 |
| ARFI imaging | Grade III-IV | 80 | 93.8 | 91 | |||||
| Lin et al. [34], 2014 | 15 | 1,867/1,525 | Meta-analysis | 28.5 | pSWE + 2-D SWE | - | 84 | 88 | 93 |
| Zhan et al. [43], 2015 | 16 | 2,456/2,147 | Meta-analysis | 30.6 | pSWE + 2-D SWE | ≥2.01-3.10 m/sec | 80 | 85 | 91 |
| Sebag et al. [3], 2010 | 1 | 146/93 | Prospective | 19.9 | 2-D SWE | Emax ≥65 kPa | 85.2 | 93.9 | 93.6 |
| Veyrieres et al. [44], 2012 | 1 | 151/148 | - | 11.8 | 2-D SWE | Emax ≥66 kPa | 80 | 90.5 | 85.2 |
| Liu et al. [28], 2014 | 1 | 64/49 | Prospective | 29.7 | 2-D SWE | Emean ≥38.3 kPa | 68 | 87 | 84 |
| Park et al. [27], 2015 | 1 | 476/453 | Retrospective | 79.6 | 2-D SWE | Emean ≥85 kPa | 43.6 | 88.7 | 68.9 |
| Emax ≥94 kPa | 46.4 | 85.6 | 68.4 | ||||||
| Azizi et al. [45], 2015 | 1 | 707/676 | Prospective | 11.6 | 2-D SWE | SWSmax ≥3.54 m/sec | 79.3 | 71.5 | 78 |
| Zhou et al. [23], 2017 | 1 | 302/290 | Prospective | 21.5 | 2-D SWE | SWSmean ≥2.60 m/sec | 84.6 | 70.0 | 89.1 |
| Kim et al. [46], 2013 | 1 | 99/99 | Retrospective | 21.2 | 2-D SWE | Emax ≥65 kPa | 76.1 | 64.1 | 75.9 |
| Emin ≥53 kPa | 61.9 | 76.1 | 69.5 | ||||||
| Emean ≥62 kPa | 66.6 | 71.6 | 76.8 | ||||||
| Dobruch-Sobczak et al. [39], 2016 | 2 | 169/119 | Prospective, dual-center | 29.6 | 2-D SWE | Emax ≥67 kPa | 42.0 | 88.2 | - |
| Hu et al. [37], 2017 | 10 | - | Meta-analysis | 17.8 | 2-D SWE | - | 79 | 87 | 83 |
| Zhao et al. [31], 2018 | 1 | 176/176 | Prospective | 35.8 | 2-D SWE | Emax ≥49.5 kPa | 74.6 | 82.3 | 83.6 |
| 3-D SWE | ESD ≥13 kPa | 74.6 | 88.5 | 83.9 |
AUROC, area under the receiver operating characteristic curve; ES, elasticity score; SR, strain ratio; pSWE, point shear-wave elastography; ARFI imaging, acoustic radiation force impulse imaging; 2-D SWE, 2-dimensional shear-wave elastography; 3-D SWE, 3-dimensional shear-wave elastography.