Malignancy Risk of Thyroid Nodules That Are Not Classifiable by the American Thyroid Association Ultrasound Risk Stratification System: A Systematic Review and Meta-Analysis
Authors' conclusion
In this first meta-analysis comprehensively assessing the RoM of NC-ATA nodules, the malignancy risk was found to be comparable with the current ATA USRSS intermediate suspicion category.
Study context
- Population
- Original studies of thyroid nodules classified using the American Thyroid Association (ATA) ultrasound risk stratification system (2016–2022) reporting the outcome of nonclassifiable (NC-ATA) nodules; PubMed/MEDLINE and EMBASE
- Participants
- 21,271 participants16 studies
- Outcome
- Pooled risk of malignancy (RoM) of NC-ATA nodules
Methodological detailsmeta-regression sensitivity analyses, 16 of 6377 screened studies included; 135 underwent full-text review
- Meta-regression sensitivity analyses
- 16 of 6377 screened studies included; 135 underwent full-text review
Pooled result
As reported in the abstract
Pooled RoM of NC-ATA nodules
Pooled risk of malignancy (RoM) estimate for NC-ATA nodules
20.3%
CI 13.0–28.7
Heterogeneity between studies (I2), p < 0.001
92.8%
Further pooled results
Single-center vs Multicenter
RoM by study type
P = 0.031
Retrospective vs Prospective
RoM by study design
P = 0.003
Pooled prevalence of NC-ATA nodules
- Pooled prevalence
- 7.8% (1872 nodules; CI 5.1-11.1)
RoM by inclusion of <1 cm nodules or geographic region
- No significant difference in RoM based on inclusion of <1 cm nodules or geographic region
Meta-regression
- Study design and use of surgical histology for diagnostic criteria contributed significantly to differences in reported RoM
Original publication
Malignancy Risk of Thyroid Nodules That Are Not Classifiable by the American Thyroid Association Ultrasound Risk Stratification System: A Systematic Review and Meta-Analysis. Thyroid. Published 13 April 2023. doi:10.
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