Unnecessary thyroid nodule biopsy rates under four ultrasound risk stratification systems: a systematic review and meta-analysis
- Abstract
- Objectives: To summarize and compare unnecessary biopsy rates and diagnostic performance in the examination of thyroid nodules according to four representative US-based risk stratification systems. Methods: MEDLINE/PubMed and EMBASE databases were searched to identify original articles investigating unnecessary biopsy rates according to at least one of the following guidelines: ACR-TIRADS, ATA, EU-TIRADS, and K-TIRADS. The unnecessary biopsy rates for each risk stratification system were pooled using a random-effects model. Meta-regression analyses were performed to explore heterogeneity. Diagnostic odds ratios (DORs) for the appropriate selection of thyroid nodules for fine-needle aspiration were also pooled using a bivariate random-effects model. Results: Eight articles including 13,092 thyroid nodules met the eligibility criteria and were included. The pooled unnecessary biopsy rates of ACR-TIRADS, ATA, EU-TIRADS, and K-TIRADS were 25% (95% CI, 22?29%), 51% (95% CI, 44?58%), 38% (95% CI, 16?66%), and 55% (95% CI, 42?67%), respectively. The pooled unnecessary biopsy rate of ACR-TIRADS was significantly lower than that of ATA (p <.001) and K-TIRADS (p <.001), and also lower than that of EU-TIRADS, but not reaching statistical significance (p =.087). The pooled DORs of ACR-TIRADS, ATA, and K-TIRADS were 5.9 (95% CI, 3.6?9.6), 6.3 (95% CI, 4.5?8.8), and 4.5 (95% CI, 1.7?11.6), respectively, with the differences not being statistically significant. Conclusions: ACR-TIRADS showed a lower unnecessary biopsy rate than the other risk stratification systems albeit DOR was comparable between ACR-TIRADS, ATA, and K-TIRADS. Future revisions of each system should be made by referring to ACR-TIRADS to reduce unnecessary biopsy rates. Key Points: ? The pooled unnecessary biopsy rates of ACR-TIRADS, ATA, EU-TIRADS, and K-TIRADS were 25% (95% CI, 22?29%), 51% (95% CI, 44?58%), 38% (95% CI, 16?66%), and 55% (95% CI, 42?67%), respectively. ? The pooled unnecessary biopsy rate of ACR-TIRADS was significantly lower than that of ATA (p <.001) and K-TIRADS (p <.001). ? The pooled DORs of ACR-TIRADS, ATA, and K-TIRADS were 5.9 (95% CI, 3.6?9.6), 6.3 (95% CI, 4.5?8.8), and 4.5 (95% CI, 1.7?11.6), respectively, with the differences not being statistically significant.
- Author(s)
- 김평화; 백정환; 서종현; 이정현; 정새롬; 최영준
- Issued Date
- 2021
- Type
- Article
- Keyword
- Biopsy; Fine-Needle; Diagnostic Radiology; Head and Neck; Humans; Imaging; Internal Medicine; Interventional Radiology; Medicine; Medicine & Public Health; Neuroradiology; Radiology; Risk Assessment; Thyroid diseases; Thyroid Nodule - diagnostic imaging; Ultrasonography; Ultrasound; Ultrasound imaging
- DOI
- 10.1007/s00330-020-07384-6
- URI
- https://oak.ulsan.ac.kr/handle/2021.oak/7971
https://ulsan-primo.hosted.exlibrisgroup.com/primo-explore/fulldisplay?docid=TN_cdi_proquest_miscellaneous_2451855481&context=PC&vid=ULSAN&lang=ko_KR&search_scope=default_scope&adaptor=primo_central_multiple_fe&tab=default_tab&query=any,contains,Unnecessary%20thyroid%20nodule%20biopsy%20rates%20under%20four%20ultrasound%20risk%20stratification%20systems:%20a%20systematic%20review%20and%20meta-analysis&offset=0&pcAvailability=true
- Publisher
- EUROPEAN RADIOLOGY
- Location
- 오스트리아
- Language
- 영어
- ISSN
- 0938-7994
- Citation Volume
- 31
- Citation Number
- 5
- Citation Start Page
- 2877
- Citation End Page
- 2885
-
Appears in Collections:
- Medicine > Medicine
- Authorize & License
-
- Files in This Item:
-
Items in Repository are protected by copyright, with all rights reserved, unless otherwise indicated.