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

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.