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Diagnostic performance of contrast‑enhanced ultrasound vs. conventional ultrasound for lymph node metastasis in patients with thyroid cancer: A meta‑analysis

  • Authors:
    • Junhui Gao
    • Ying Liu
    • Lipeng Zheng
    • Xiaogang Wang
    • Yingluan Wang
    • Tongxia Zhou
  • View Affiliations / Copyright

    Affiliations: Department of Ultrasound Medicine, Zibo Municipal Hospital, Zibo, Shandong 255400, P.R. China, Department of Ultrasound Medicine, Zibo Municipal Hospital, Zibo, Shandong 255400, P.R. China, Department of Electrocardiogram Diagnosis, Zibo Municipal Hospital, Zibo, Shandong 255400, P.R. China
    Copyright: © Gao et al. This is an open access article distributed under the terms of Creative Commons Attribution License.
  • Article Number: 407
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    Published online on: June 24, 2025
       https://doi.org/10.3892/ol.2025.15153
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Abstract

The ability of conventional ultrasound (US) and contrast‑enhanced (CE)US to diagnose lymph node metastasis in patients with thyroid cancer has been explored, but there is a lack of a pooled analysis. In the present study, a meta‑analysis was performed to explore the diagnostic performance of conventional US and CEUS for lymph node metastasis in patients with thyroid cancer. The PubMed, Web of Science, Embase and Cochrane Library databases were searched to identify studies related to the diagnosis of lymph node metastasis using CEUS and conventional US in patients with thyroid cancer published until February 2024. This meta‑analysis incorporated 9 studies, involving a total of 1,226 patients with thyroid cancer. The quality assessment of diagnostic accuracy studies‑2 tool suggested that the quality of the included studies was good. A summary receiver operating characteristic analysis was performed to assess the diagnostic performance of conventional US and CEUS. The pooled sensitivity [95% confidence interval (CI)], specificity (95% CI) and the area under curve (AUC) of conventional US for diagnosing lymph node metastasis were 0.77 (0.73‑0.80), 0.72 (0.68‑0.76) and 0.7925, respectively, in patients with thyroid cancer, while the parameters of CEUS were 0.85 (0.82‑0.88), 0.86 (0.82‑0.89) and 0.9216, respectively. Overall, the pooled sensitivity, specificity and AUC of CEUS for diagnosing lymph node metastasis were higher than those of conventional US in patients with thyroid cancer (all P<0.001). Deeks' asymmetry test suggested that no publication bias existed in this meta‑analysis. In conclusion, CEUS shows a better ability to diagnose lymph node metastasis than the conventional US in patients with thyroid cancer.
View Figures

Figure 1

Flow chart of study selection. CEUS,
contrast-enhanced ultrasound.

Figure 2

Risk of bias assessed using quality
assessment of diagnostic accuracy studies-2 tools. (A) The
proportion of studies with high, unclear and low risk of bias, as
well as applicability concerns. (B) Detailed information on each
study with high, unclear and low risk of bias, as well as
applicability concerns.

Figure 3

Forest plots for sensitivity and
specificity of conventional US. (A) Sensitivity and (B) specificity
of conventional US for diagnosing lymph node metastasis in patients
with thyroid cancer. US, ultrasound; df, degrees of freedom.

Figure 4

SROC curve of the diagnostic
performance of conventional US. US, ultrasound; SROC, summary
receiver operating characteristic; AUC, area under the SROC curve;
SE, standard error.

Figure 5

Forest plots for sensitivity and
specificity of CEUS. (A) Sensitivity and (B) specificity of CEUS
for diagnosing lymph node metastasis in patients with thyroid
cancer. CEUS, contrast-enhanced ultrasound; df, degrees of
freedom.

Figure 6

SROC curve of the diagnostic
performance of CEUS. CEUS, contrast-enhanced ultrasound; SROC,
summary receiver operating characteristic; AUC, area under the SROC
curve; SE, standard error.

Figure 7

Publication bias assessed by Deeks'
funnel plot asymmetry test. Deeks' funnel plot asymmetry test for
(A) conventional US and (B) CEUS. CEUS, contrast-enhanced
ultrasound. ESS, effective sample size.
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Copy and paste a formatted citation
Spandidos Publications style
Gao J, Liu Y, Zheng L, Wang X, Wang Y and Zhou T: Diagnostic performance of contrast‑enhanced ultrasound vs. conventional ultrasound for lymph node metastasis in patients with thyroid cancer: A meta‑analysis. Oncol Lett 30: 407, 2025.
APA
Gao, J., Liu, Y., Zheng, L., Wang, X., Wang, Y., & Zhou, T. (2025). Diagnostic performance of contrast‑enhanced ultrasound vs. conventional ultrasound for lymph node metastasis in patients with thyroid cancer: A meta‑analysis. Oncology Letters, 30, 407. https://doi.org/10.3892/ol.2025.15153
MLA
Gao, J., Liu, Y., Zheng, L., Wang, X., Wang, Y., Zhou, T."Diagnostic performance of contrast‑enhanced ultrasound vs. conventional ultrasound for lymph node metastasis in patients with thyroid cancer: A meta‑analysis". Oncology Letters 30.3 (2025): 407.
Chicago
Gao, J., Liu, Y., Zheng, L., Wang, X., Wang, Y., Zhou, T."Diagnostic performance of contrast‑enhanced ultrasound vs. conventional ultrasound for lymph node metastasis in patients with thyroid cancer: A meta‑analysis". Oncology Letters 30, no. 3 (2025): 407. https://doi.org/10.3892/ol.2025.15153
Copy and paste a formatted citation
x
Spandidos Publications style
Gao J, Liu Y, Zheng L, Wang X, Wang Y and Zhou T: Diagnostic performance of contrast‑enhanced ultrasound vs. conventional ultrasound for lymph node metastasis in patients with thyroid cancer: A meta‑analysis. Oncol Lett 30: 407, 2025.
APA
Gao, J., Liu, Y., Zheng, L., Wang, X., Wang, Y., & Zhou, T. (2025). Diagnostic performance of contrast‑enhanced ultrasound vs. conventional ultrasound for lymph node metastasis in patients with thyroid cancer: A meta‑analysis. Oncology Letters, 30, 407. https://doi.org/10.3892/ol.2025.15153
MLA
Gao, J., Liu, Y., Zheng, L., Wang, X., Wang, Y., Zhou, T."Diagnostic performance of contrast‑enhanced ultrasound vs. conventional ultrasound for lymph node metastasis in patients with thyroid cancer: A meta‑analysis". Oncology Letters 30.3 (2025): 407.
Chicago
Gao, J., Liu, Y., Zheng, L., Wang, X., Wang, Y., Zhou, T."Diagnostic performance of contrast‑enhanced ultrasound vs. conventional ultrasound for lymph node metastasis in patients with thyroid cancer: A meta‑analysis". Oncology Letters 30, no. 3 (2025): 407. https://doi.org/10.3892/ol.2025.15153
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