Liu Yanshen, Xu Weiming
Department of Ultrasound, Chang'an Branch of The Medical Community of Fuyang District Traditional Chinese Medicine Hospital Hangzhou, Zhejiang, China.
Department of Gastroenterology, The First People's Hospital of Fuyang Hangzhou Hangzhou, Zhejiang, China.
Am J Transl Res. 2025 Aug 15;17(8):6556-6572. doi: 10.62347/BNBG2830. eCollection 2025.
To systematically evaluate the diagnostic performance of high-frequency ultrasound and its sonographic features in the early detection of thyroid cancer through a meta-analysis.
A comprehensive search was conducted in PubMed, Embase, and Web of Science for studies published up to December 31, 2024. Studies assessing the diagnostic performance of high-frequency ultrasound and ultrasound-guided procedures for thyroid cancer were included based on predefined criteria. Extracted data included sensitivity, specificity, and the diagnostic relevance of sonographic features (e.g., nodule size, margin irregularity, echogenicity, calcifications, and vascularity). Study quality was assessed using the Quality Assessment of Diagnostic Accuracy Studies (QUADAS) tool. Meta-analytic methods were applied to pool diagnostic accuracy measures. Publication bias was evaluated using funnel plots.
A total of 14 studies were included. Combined diagnostic approaches, particularly high-frequency ultrasound combined with ultrasound-guided fine-needle aspiration biopsy (US-FNAB), demonstrated high sensitivity (ranging from 0.814 to 0.975) and specificity (ranging from 0.833 to 0.976). Key sonographic features significantly associated with malignancy included hypoechogenicity, microcalcifications, and irregular margins. Pooled analysis showed that microcalcifications and irregular margins were strong predictors for malignancy, with an overall Peto odds ratios (OR) of 39.47 [28.88, 53.94] for irregular margins (P<0.001). Minimal publication bias was observed for most features, although mild asymmetry was noted in analyses involving microcalcifications.
High-frequency ultrasound, particularly when combined with ultrasound-guided biopsy or contrast-enhanced ultrasound, provides high diagnostic accuracy for thyroid cancer. Specific features, such as hypoechogenicity, microcalcifications, and irregular margins, are valuable in differentiating malignant from benign thyroid nodules. Future studies should aim to standardize ultrasound-based diagnostic criteria and explore the use of multimodal imaging techniques to improve early thyroid cancer detection.
通过荟萃分析系统评价高频超声及其超声特征在甲状腺癌早期检测中的诊断性能。
在PubMed、Embase和Web of Science中全面检索截至2024年12月31日发表的研究。根据预定义标准纳入评估高频超声及超声引导程序对甲状腺癌诊断性能的研究。提取的数据包括敏感性、特异性以及超声特征（如结节大小、边缘不规则、回声性、钙化和血管形成）的诊断相关性。使用诊断准确性研究质量评估（QUADAS）工具评估研究质量。应用荟萃分析方法汇总诊断准确性指标。使用漏斗图评估发表偏倚。
共纳入14项研究。联合诊断方法，特别是高频超声联合超声引导下细针穿刺活检（US-FNAB），显示出高敏感性（范围为0.814至0.975）和特异性（范围为0.833至0.976）。与恶性肿瘤显著相关的关键超声特征包括低回声、微钙化和边缘不规则。汇总分析表明，微钙化和边缘不规则是恶性肿瘤的强预测指标，边缘不规则的总体Peto比值比（OR）为39.47 [28.88, 53.94]（P<0.001）。大多数特征观察到最小发表偏倚，尽管在涉及微钙化的分析中注意到轻度不对称。
高频超声，特别是与超声引导活检或超声造影联合使用时，对甲状腺癌具有较高的诊断准确性。低回声、微钙化和边缘不规则等特定特征在鉴别甲状腺良恶性结节方面具有重要价值。未来研究应旨在规范基于超声的诊断标准，并探索使用多模态成像技术以改善甲状腺癌的早期检测。
