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European Radiology
Erschienen in: European Radiology 9/2019

26.02.2019 | Computed Tomography

Diagnostic performance of CT in detection of metastatic cervical lymph nodes in patients with thyroid cancer: a systematic review and meta-analysis

verfasst von: Se Jin Cho, Chong Hyun Suh, Jung Hwan Baek, Sae Rom Chung, Young Jun Choi, Jeong Hyun Lee

Erschienen in: European Radiology | Ausgabe 9/2019

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Abstract

Objectives

Although ultrasound (US) is a standard modality for the assessment of cervical lymph node metastasis in patients with thyroid cancer, there is an increasing trend in the number of articles describing the use of contrast-enhanced computed tomography (CT). The purpose of this systematic review and meta-analysis was to evaluate the diagnostic performance of CT in the diagnosis of metastatic cervical lymph nodes and to identify the parameters responsible for heterogeneity in diagnostic performance.

Methods

Ovid-MEDLINE and EMBASE databases were searched up to May 22, 2018, for studies on the diagnostic performance of CT. The pooled sensitivity and specificity of all studies were calculated. In addition, subgroup analysis and meta-regression analysis were performed to evaluate factors responsible for heterogeneity.

Results

Seventeen (6378 patients, 11,590 lymph nodes) studies were included. The pooled sensitivity was 55% (95% CI, 47–63%), and the pooled specificity was 87% (95% CI, 90–95%). Higgins I2 statistic demonstrated substantial heterogeneity in the sensitivity (I2 = 96.3%) and specificity (I2 = 93.8%). In a per-neck level subgroup analysis, the Higgins I2 statistic demonstrated reduced heterogeneity in both sensitivity and specificity. In the meta-regression analysis, variation in the CT protocols, such as contrast amount, scan phase, and reconstruction slice thickness, was a statistically significant factor causing heterogeneity.

Conclusions

CT demonstrated acceptable diagnostic performance in the pre- and postoperative diagnosis of metastatic cervical lymph nodes in patients with thyroid cancer. Variation in the CT protocols was a main factor causing heterogeneity among the included studies.

Key Points

• The role of contrast-enhanced computed tomography (CT) needs to be reassessed.
• CT demonstrated acceptable diagnostic performance in the diagnosis of metastatic cervical lymph nodes in patients with thyroid cancer in the meta-analysis.
• Variation in the CT protocols was a main factor causing heterogeneity in the meta-regression analysis.
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Metadaten
Titel
Diagnostic performance of CT in detection of metastatic cervical lymph nodes in patients with thyroid cancer: a systematic review and meta-analysis
verfasst von
Se Jin Cho
Chong Hyun Suh
Jung Hwan Baek
Sae Rom Chung
Young Jun Choi
Jeong Hyun Lee
Publikationsdatum
26.02.2019
Verlag
Springer Berlin Heidelberg
Erschienen in
European Radiology / Ausgabe 9/2019
Print ISSN: 0938-7994
Elektronische ISSN: 1432-1084
DOI
https://doi.org/10.1007/s00330-019-06036-8

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