229 Diagnostic utility of molecular and imaging biomarkers 2 Table 52. Estimated pooled test performance of individual US characteristics in Bethesda III thyroid nodules number of studies ni TP FP FN TN malignant (TP+FN/ni) sensitivity (95% CI), % specificity (95% CI), % LR+ (95% CI) LR- (95% CI) AUC (95% CI) Solitary thyroid nodule 3 600 79 121 140 260 36.5% 36 (30-42) 69 (63-74) n.a.c. n.a.c. n.a.c. Solid thyroid nodule 9 1,518 530 742 57 189 38.7% 90.4 (87.1-93.0) 19.8 (16.5-23.5) 1.13 (1.07-1.19) 0.48 (0.34-0.69) 0.55 (0.51-0.60) Hypoechogenicity 10 1,601 291 303 259 748 34.4% 60.0 (38.9-77.9) 75.6 (54.6-88.9) 2.46 (1.59-3.79) 0.53 (0.38-0.73) 0.73 (0.69-0.77) Size >4 cm 0 0 0 0 0 0 n.a. n.a. n.a. n.a. n.a. n.a. Taller-than-wide shape 8 1,256 198 120 260 678 36.5% 43.5 (37.5-49.8) 87.1 (79.0-92.3) 3.36 (2.17-5.21) 0.65 (0.59-0.71) 0.58 (0.53-0.62) Absence of halo sign 4 694 158 226 48 262 29.7% 77.6 (30.4-96.5) 47.8 (13.8-84.0) 1.49 (0.98-2.25) 0.47 (0.21-1.03) n.a.c. Irregular margins 10 1,601 348 284 202 767 34.4% 58.5 (47.9-68.5) 79.2 (67.8-87.3) 2.81 (1.99-3.98) 0.52 (0.44-0.62) 0.73 (0.69-0.77) Intranodular vascularization 6 1,030 94 183 204 549 28.9% 34.5 (19.3-53.7) 80.3 (66.3-89.4) 1.75 (0.72-4.25) 0.82 (0.58-1.15) 0.63 (0.59-0.67) Microcalcifications 9 1,331 176 124 293 738 35.2% 39.2 (31.6-48.0) 86.0 (75.0-92.6) 2.82 (1.53-5.22) 0.70 (0.60-0.82) 0.52 (0.47-0.56) Macrocalcifications 10 1,607 158 227 465 757 38.8% 22.1 (14.0-33.0) 79.4 (73.5-84.2) 1.07 (0.82-1.41) 0.98 (0.91-1.06) 0.63 (0.59-0.67) AUC: area under the summary receiver operator characteristic curve. FN: false negative. FP: false positive. LR+: positive likelihood ratio. LR-: negative likelihood ratio. n.a.: not applicable. n.a.c.: not able to calculate. ni : number of indeterminate nodules. TN: true negative. TP: true positive.
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