Sonoelastography for differential diagnosis between malignant and benign parotid lesions: a meta-analysis

OBJECTIVES: To assess the performance of sonoelastography for differential diagnosis between malignant and benign parotid lesions using a meta-analysis. METHODS: An independent literature search of English medical databases, such as PubMed, Embase and Medline (Embase.com), Web of Science, Cochrane Library and Ovid was performed. The diagnostic accuracy of sonoelastography was compared with that of histopathology and/or cytology, which was used as reference standard. The pooled sensitivity, specificity, diagnostic odds ratio (DOR) and area under the curve (AUC) were calculated to evaluate the accuracy of sonoelastography. A meta-regression analysis evaluating imaging mechanisms, shear wave elastography techniques, assessment methods and QUADAS scores was performed. RESULTS: Ten eligible studies that included a total sample of 711 patients with 725 parotid lesions were included. Sonoelastography showed a pooled sensitivity of 0.67 (95% CI 0.59–0.74), specificity of 0.64 (95% CI 0.60–0.68), DOR of 8.00 (95% CI 2.96–21.63) and an AUC of 0.77. The results of the meta-regression analysis revealed that no heterogeneity was due to the imaging mechanism (p = 0.119), shear wave elastography technique (p = 0.473) or QUADAS score (p = 0.462). However, the assessment method was a significant factor that affected the study heterogeneity (p = 0.035). According to the subgroup analysis, quantitative and semiquantitative methods performed better than qualitative ones. CONCLUSION: Overall, sonoelastography has a limited value for differential diagnosis between malignant and benign parotid lesions. Quantitative and semiquantitative methods perform better than qualitative ones. KEY POINTS: • Overall, sonoelastography has a limited value for differential diagnosis between malignant and benign parotid lesions. • Quantitative and semiquantitative assessment methods perform better than qualitative ones. • Semiquantitative and quantitative methods are automatically calculated by an ultrasound machine and are thus less operator-dependent.