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Compression Real‐time Elastography for Evaluation of Salivary Gland Lesions
Author(s) -
Li Changtian,
Zhang Changsheng,
Li Nan,
Li Junlai
Publication year - 2016
Publication title -
journal of ultrasound in medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.574
H-Index - 91
eISSN - 1550-9613
pISSN - 0278-4297
DOI - 10.7863/ultra.15.08043
Subject(s) - funnel plot , medicine , elastography , confidence interval , publication bias , receiver operating characteristic , subgroup analysis , area under the curve , nuclear medicine , radiology , ultrasound
Objectives To evaluate the performance of compression real‐time elastography for differentiation between benign and malignant salivary gland lesions. Methods A systematic literature database search was conducted. Pooled sensitivity, specificity, positive likelihood ratio (LR+), and negative likelihood ratio (LR−) values for real‐time elastography were analyzed. Summary receiver operating characteristic (ROC) curves were also constructed. Heterogeneity was evaluated by χ 2 and I 2 tests. I 2 > 50% or P < .05 indicated heterogeneity, and then a random‐effects model was applied. A Deek funnel plot was used to assess publication bias. Fagan plot analysis was performed to evaluate the clinical utility of real‐time elastography. When heterogeneity was found, subgroup analyses were used to explore the sources of heterogeneity. A sensitivity analysis was conducted by omitting 1 study at a time and examining the influence of each individual study on the overall results. Results Nine articles with 581 lesions were included. The pooled sensitivity and specificity of real‐time elastography for differentiation between benign and malignant lesions were 76% (95% confidence interval [CI], 65%–85%; 95% prediction interval [PI], 29%–95%) and 73% (95% CI, 62%–81%; 95% PI, 24%–96%), respectively. The LR+ and LR− were 2.81 (95% CI, 1.79–4.39; 95% PI, 0.65–12.16) and 0.33 (95% CI, 0.20–0.55; 95% PI, 0.07–1.69). The area under the ROC curve was 0.81 (95% CI, 0.77–0.84). No publication bias was detected, according to the Deek funnel plot ( P = .51). The Fagan plot showed that when pretest probabilities were 25%, 50%, and 75%, positive posttest probabilities were 48%, 74%, and 89%, and negative probabilities were 10%, 25%, and 50%. Conclusions Real‐time elastography is a novel supplementary adjunct to conventional sonography for evaluation of salivary gland lesions. However, its overall accuracy is less promising, and biopsy may still be necessary in routine clinical practice.