Enhancing Thyroid Nodule Assessment: Leveraging Contrast-Enhanced Ultrasonography as a Screening Modality - A Meta-Analysis

Abstract

Introduction: - CEUS has become an emerging radio diagnostic technique of modern times. The use of these contrasts offers a way better alternative than materials that cause radiation. Thyroid nodules are notorious for their effect on normal physiology and the routine best diagnostic modality apart from biopsy is Radioactive Iodine. Aim:- To conduct a diagnostic test accuracy meta-analysis to understand the role of CEUS in diagnosing thyroid nodules. Methodology:- According to Prisma guidelines, literature on the topic was found using the Keywords CEUS, Thyroid Nodule, and Radioactive Iodine. Two independent reviewers conducted a quality check on the papers and decided on the studies that should be included. Any discrepancies were solved by a third reviewer. Meta Disc, Review Manager, and Excel were used to analyze the extracted data from the selected studies as per the inclusion and exclusion criteria. Biopsy was taken as a Reference Gold Standard. Result:- A total of 47 RCTs with 5,527 patients were selected for the study. The pooled sensitivity of CEUS is 0.87, with a CI of 95% in a range of 0.86 to 0.88. The specificity of CEUS is 0.84, with a CI of 95% in a range of 0.82 to 0.85. The summary of the ROC curve shows that the area under the curve for CEUS was 0.9292 and the overall diagnostic odds ratio (DOR) was 40.59. Conclusion:- It can be concluded from the results that CEUS can be used as a Screening tool for high suspicion groups but it is still not a perfect test. The newer generation of Contrasts may yield higher accuracy but for the currently available contrasts, Biopsy remains the best tool for a definitive and accurate diagnosis. Keywords:- Thyroid Nodule, Contrast-Enhanced Ultrasound, Benign, Malignant, Prognosis