250 chapter 2 [99mTc]Tc-MIBI Our systematic literature search yielded three studies that investigated the role of [99mTc]Tc-MIBI (Table 59). We performed a meta-analysis, including a total of 199 indeterminate thyroid nodules [58, 296, 351]. A positive [99mTc]Tc-MIBI scan was reported in 42.2% (84/199). Pooled sensitivity, specificity, positive and negative LR are 67% (95% CI: 53%-82%), 68% (95% CI: 36%-100), 2.37 (95% CI: 0.94-5.95) and 0.53 (95% CI: 0.30-0.94) (Table 60, Table 61, Figure 83). For a population of indeterminate thyroid nodules with a given prevalence of malignancy of 15%, 25% or 40%, the [99mTc] Tc-MIBI test performance corresponds to a PPV and NPV of 29.5% (95% CI: 14.2%-51.2%) and 91.4% (95% CI: 85.8%-95.0%), 44.1% (95% CI: 23.9%-66.5%) and 85.0% (95% CI: 76.1%-90.9%), or 61.2% (95% CI: 38.5%-79.9%) and 73.9% (95% CI: 61.5%-83.3%), respectively. Results of best-case and worstcase scenarios are identical to the presented results as histopathology was available in all cases. [99mTc]Tc-MIBI in thyroid nodules with Hürthle cell cytology Malignant as well as benign Hürthle cell nodules frequently show a more frequent, intense and persistent [99mTc]Tc-MIBI uptake [296-298]. Treglia et al. suggested that diagnostic accuracy of [99mTc]Tc-MIBI might increase when the tested population is limited to non-oncocytic lesions [293]. Therefore, we performed a subgroup analysis including only data of the qualitative assessments of Figure 82. SROC curve of semiquantitative elastosonography Summary receiver operating characteristic plot showing sensitivity versus 1-specificity of semiquantitative elastosonography in indeterminate thyroid nodules with available histopathology. AUC: not able to calculate using Stata MP due to limitations to data. AUC, area under the curve; HSROC, hierarchical summary receiver operating characteristic.
RkJQdWJsaXNoZXIy MTk4NDMw