title: Contrast-enhanced sonography for the identification of benign and malignant thyroid nodules: Systematic review and meta-analysis.
abstract: OBJECTIVE
  The use of contrast-enhanced sonography (CEUS) has yielded promising results in the differentiation of thyroid nodules. We conducted this meta-analysis to assess its performance in identifying and distinguishing between benign and malignant thyroid nodules.
  
  
  METHODS
  PubMed, Medline, Embase, and the Cochrane Library were searched for studies published through the end of December 2013. Sensitivity, specificity, positive and negative likelihood ratios, diagnostic odds ratio, and area under the curve were calculated.
  
  
  RESULTS
  A total of 13 studies were included in this meta-analysis. For the diagnosis of malignant thyroid nodules worldwide, the overall mean rates of sensitivity and specificity of CEUS were 90% (95% confidence interval [CI], 88-93%) and 86% (95% CI, 83-89%), respectively. The summary diagnostic odds ratio was 52.83 (95% CI, 21.71-128.55), and the area under the curve for the summary receiver operating characteristic curve was 0.94 (95% CI, 0.90-0.98).
  
  
  CONCLUSIONS
  This meta-analysis indicates that CEUS may be a valuable supplemental method, with high rates of sensitivity and specificity, to use for identifying and distinguishing between benign and malignant thyroid nodules.
authors.affiliation: Department of Medical Oncology, Cancer Center, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, 610041, People's Republic of China.
authors.forename: Xuelei
authors.initials: X
authors.lastname: Ma
authors.affiliation: Department of Medical Oncology, Cancer Center, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, 610041, People's Republic of China.
authors.forename: Binglan
authors.initials: B
authors.lastname: Zhang
authors.affiliation: Department of Sonography, West China Hospital, Sichuan University, Chengdu, 610041, People's Republic of China.
authors.forename: Wenwu
authors.initials: W
authors.lastname: Ling
authors.affiliation: Sichuan University, Chengdu, 610041, People's Republic of China.
authors.forename: Rongjun
authors.initials: R
authors.lastname: Liu
authors.affiliation: Department of Medical Oncology, Cancer Center, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, 610041, People's Republic of China.
authors.forename: Hongyuan
authors.initials: H
authors.lastname: Jia
authors.affiliation: Department of Hepatobiliary Surgery, Ninth People's Hospital of Chongqing, Chongqing, 400700, People's Republic of China.
authors.forename: Fuping
authors.initials: F
authors.lastname: Zhu
authors.affiliation: Sichuan University, Chengdu, 610041, People's Republic of China.
authors.forename: Mengyao
authors.initials: M
authors.lastname: Wang
authors.affiliation: Sichuan University, Chengdu, 610041, People's Republic of China.
authors.forename: Haoqiu
authors.initials: H
authors.lastname: Liu
authors.affiliation: Sichuan University, Chengdu, 610041, People's Republic of China.
authors.forename: Jingwen
authors.initials: J
authors.lastname: Huang
authors.affiliation: Department of Medical Oncology, Cancer Center, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, 610041, People's Republic of China.
authors.forename: Lei
authors.initials: L
authors.lastname: Liu
mesh_terms: D003287:Contrast Media / Q000494:pharmacology*; D003937:Diagnosis, Differential; D006801:Humans; D015203:Reproducibility of Results; D013961:Thyroid Gland / Q000000981:diagnostic imaging*; D016606:Thyroid Nodule / Q000175:diagnosis*; D014463:Ultrasonography / Q000379:methods*
chemical_list: D003287:Contrast Media
keywords: contrast-enhanced ultrasonography; diagnosis; meta-analysis; thyroid nodules