230 chapter 2 Table 53. Estimated pooled test performance of individual US characteristics in Bethesda IV 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 6 699 83 222 177 217 37.2% 48.1 (28.2-68.6) 51.0 (35.0-66.8) 0.98 (0.54-1.78) 1.02 (0.58-1.78) 0.50 (0.45-0.54) Solid thyroid nodule 8 784 155 381 55 193 26.8% 74.8 (65.0-82.6) 28.6 (17.3-43.4) 1.05 (0.91-1.20) 0.88 (0.62-1.25) 0.62 (0.58-0.66) Hypoechogenicity 10 1,157 186 341 142 488 28.3% 57.2 (47.0-66.7) 62.6 (51.2-72.8) 1.53 (1.16-2.01) 0.68 (0.54-0.86) 0.62 (0.58-0.66) Size >4 cm 5 386 23 40 80 243 26.7% 22.2 (14.7-32.1) 87.3 (80.0-92.1) 1.75 (1.02-2.97) 0.89 (0.79-1.00) 0.45 (0.41-0.50) Taller-than-wide shape 4 637 45 44 138 410 28.7% 22.9 (15.2-33.1) 95.1 (81.9-98.8) 4.69 (1.45-15.20) 0.81 (0.74-0.89) n.a.c. Absence of halo sign 3 359 86 147 22 104 30.1% 79 (69-90) 39 (-18-97) n.a.c. n.a.c. n.a.c. Irregular margins 8 947 64 43 215 625 29.5% 23.3 (15.6-33.2) 95.0 (87.4-98.1) 4.63 (1.64-13.10) 0.81 (0.71-0.92) 0.51 (0.47-0.55) Intranodular vascularization 5 541 42 74 81 344 22.7% 35.6 (18.3-57.6) 90.0 (73.9-96.6) 3.57 (1.41-9.05) 0.72 (0.54-0.95) 0.68 (0.64-0.72) Microcalcifications 8 994 102 65 172 655 27.6% 42.1 (15.8-73.8) 90.4 (79.5-95.8) 4.38 (2.57-7.47) 0.64 (0.39-1.06) 0.84 (0.80-0.87) Macrocalcifications 2 172 14 17 44 97 33.7% 24 (13-35) 95 (92-99) n.a.c. n.a.c. n.a.c. 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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