Diagnostic Accuracy of Machine Learning-Based Radiomics in Grading Gliomas: Systematic Review and Meta-Analysis

Purpose. This study aimed to estimate the diagnostic accuracy of machine learning- (ML-) based radiomics in differentiating high-grade gliomas (HGG) from low-grade gliomas (LGG) and to identify potential covariates that could affect the diagnostic accuracy of ML-based radiomic analysis in classifying gliomas. Method. A primary literature search of the PubMed database was conducted to find all related literatures in English between January 1, 2009, and May 1, 2020, with combining synonyms for “machine learning,” “glioma,” and “radiomics.” Five retrospective designed original articles including LGG and HGG subjects were chosen. Pooled sensitivity, specificity, their 95% confidence interval, area under curve (AUC), and hierarchical summary receiver-operating characteristic (HSROC) models were obtained. Result. The pooled sensitivity when diagnosing HGG was higher (96% (95% CI: 0.93, 0.98)) than the specificity when diagnosing LGG (90% (95% CI 0.85, 0.93)). Heterogeneity was observed in both sensitivity and specificity. Metaregression confirmed the heterogeneity in sample sizes ( p = 0.05 ), imaging sequence types ( p = 0.02 ), and data sources ( p = 0.01 ), but not for the inclusion of the testing set ( p = 0.19 ), feature extraction number ( p = 0.36 ), and selection of feature number ( p = 0.18 ). The results of subgroup analysis indicate that sample sizes of more than 100 and feature selection numbers less than the total sample size positively affected the diagnostic performance in differentiating HGG from LGG. Conclusion. This study demonstrates the excellent diagnostic performance of ML-based radiomics in differentiating HGG from LGG.

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The role of serum periostin in the diagnosis of asthma: A meta-analysis

Allergy and Asthma Proceedings ◽

10.2500/aap.2020.41.200038 ◽

2020 ◽

Vol 41 (4) ◽

pp. 240-247

Author(s):

Lei Yang ◽

Qingtao Zhao ◽

Shuyu Wang

Keyword(s):

Diagnostic Accuracy ◽

Meta Analysis ◽

Characteristic Curve ◽

False Negative ◽

Summary Receiver Operating Characteristic ◽

True Negative ◽

Negative Results ◽

Noninvasive Biomarker ◽

Sensitivity Specificity ◽

Serum Periostin

Background: Serum periostin has been proposed as a noninvasive biomarker for asthma diagnosis and management. However, its accuracy for the diagnosis of asthma in different populations is not completely clear. Methods: This meta-analysis aimed to evaluate the diagnostic accuracy of periostin level in the clinical determination of asthma. Several medical literature data bases were searched for relevant studies through December 1, 2019. The numbers of patients with true-positive, false-positive, false-negative, and true-negative results for the periostin level were extracted from each individual study. We assessed the risk of bias by using Quality Assessment of Diagnostic Accuracy Studies 2. We used the meta-analysis to produce summary estimates of accuracy. Results: In total, nine studies with 1757 subjects met the inclusion criteria. The pooled estimates of sensitivity, specificity, and diagnostic odds ratios for the detection of asthma were 0.58 (95% confidence interval [CI], 0.38‐0.76), 0.86 (95% CI, 0.74‐0.93), and 8.28 (95% CI, 3.67‐18.68), respectively. The area under the summary receiver operating characteristic curve was 0.82 (95% CI, 0.79‐0.85). And significant publication bias was found in this meta‐analysis (p = 0.39). Conclusion: Serum periostin may be used for the diagnosis of asthma, with moderate diagnostic accuracy.

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Meta-Analysis: Urinary Calprotectin for Discrimination of Intrinsic and Prerenal Acute Kidney Injury

Journal of Clinical Medicine ◽

10.3390/jcm8010074 ◽

2019 ◽

Vol 8 (1) ◽

pp. 74 ◽

Cited By ~ 2

Author(s):

Jia-Jin Chen ◽

Pei-Chun Fan ◽

George Kou ◽

Su-Wei Chang ◽

Yi-Ting Chen ◽

...

Keyword(s):

Acute Kidney Injury ◽

Diagnostic Accuracy ◽

Diagnostic Performance ◽

Pediatric Population ◽

Meta Analysis ◽

Positive Likelihood Ratio ◽

Kidney Injury ◽

Diagnostic Odds Ratio ◽

Summary Receiver Operating Characteristic ◽

Significant Difference

Background: Urinary calprotectin is a novel biomarker that distinguishes between intrinsic or prerenal acute kidney injury (AKI) in different studies. However, these studies were based on different populations and different AKI criteria. We evaluated the diagnostic accuracy of urinary calprotectin and compared its diagnostic performance in different AKI criteria and study populations. Method: In accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, we searched PubMed, Embase, and the Cochrane database up to September 2018. The diagnostic performance of urinary calprotectin (sensitivity, specificity, predictive ratio, and cutoff point) was extracted and evaluated. Result: This study included six studies with a total of 502 patients. The pooled sensitivity and specificity were 0.90 and 0.93, respectively. The pooled positive likelihood ratio (LR) was 15.15, and the negative LR was 0.11. The symmetric summary receiver operating characteristic (symmetric SROC) with pooled diagnostic accuracy was 0.9667. The relative diagnostic odds ratio (RDOC) of the adult to pediatric population and RDOCs of different acute kidney injury criteria showed no significant difference in their diagnostic accuracy. Conclusion: Urinary calprotectin is a good diagnostic tool for the discrimination of intrinsic and prerenal AKI under careful inspection after exclusion of urinary tract infection and urogenital malignancies. Its performance is not affected by different AKI criteria and adult or pediatric populations.

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Diagnostic Performance of Two-Dimensional Speckle Tracking Echocardiography for Detection of Obstructive Coronary Artery Disease: A Meta-Analysis.

10.22541/au.160952100.08353836/v1 ◽

2021 ◽

Author(s):

Arun Kannan ◽

Jaspreet Singh ◽

Vincent Sorrell ◽

Aiden Abidov

Keyword(s):

Confidence Interval ◽

Diagnostic Accuracy ◽

Odds Ratio ◽

Diagnostic Performance ◽

Stress Echocardiography ◽

Longitudinal Strain ◽

Speckle Tracking Echocardiography ◽

Meta Analysis ◽

Artery Disease ◽

Sensitivity Specificity

Background: Two-dimensional speckle tracking echocardiography (STE) is a quantitative myocardial strain imaging technique in evaluating global and segmental myocardial deformation. The aim of the meta-analysis was to determine the diagnostic accuracy of STE in the detection of significant coronary artery disease (CAD) in patients undergoing resting or stress echocardiography. Methods: We performed a literature search in PubMed and Medline until March 2020 for studies evaluating the role of STE in diagnosing CAD. We assessed the diagnostic performance of STE in detecting CAD by using the pooled estimate of sensitivity, specificity, likelihood ratio, diagnostic odds ratio and diagnostic accuracy. We analyzed longitudinal strain data that were reported in resting and stress echocardiography. Results: A total of 17 studies (n=1762) were included for the analysis. 12 studies (n=1239) reported global longitudinal strain (GLS) in resting echocardiography and 5 studies (n=523) reported GLS in stress echocardiography. Overall, in resting echocardiography studies, pooled GLS sensitivity and specificity for predicting obstructive CAD data were calculated to be 79% (95% confidence interval 74-83%) and 77% (95% confidence interval 72-82%), respectively. The pooled odds ratio was 13.6 (95% confidence interval 8.7-21.5). When we considered the dobutamine stress echocardiograms alone, the sensitivity and specificity in predicting obstructive CAD was 77% (95% confidence interval 59-89%) and 78% (95% confidence interval 53-92%), respectively. The odds ratio was 12.6 (95% confidence interval 2.7-58.5). Conclusions: In this meta-analysis of patients with suspected CAD, we found that STE could effectively detect obstructive CAD with a high diagnostic sensitivity, specificity and diagnostic accuracy

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Diagnostic Value of Autoantibodies in Lung Cancer: a Systematic Review and Meta-Analysis

Cellular Physiology and Biochemistry ◽

10.1159/000495935 ◽

2018 ◽

Vol 51 (6) ◽

pp. 2631-2646 ◽

Cited By ~ 7

Author(s):

Jiangyue Qin ◽

Ni Zeng ◽

Ting Yang ◽

Chun Wan ◽

Lei Chen ◽

...

Keyword(s):

Lung Cancer ◽

Diagnostic Accuracy ◽

Test Performance ◽

Meta Analysis ◽

Cyclin B1 ◽

Diagnostic Value ◽

Likelihood Ratios ◽

Summary Receiver Operating Characteristic ◽

Mixed Effect ◽

Sensitivity Specificity

Background/Aims: Recently, many studies have demonstrated that various tumor-associated autoantibodies have been detected in early stages of lung cancer. Therefore, we conducted a meta-analysis to comprehensively evaluate available evidence on the diagnostic value of autoantibodies against tumor-associated antigens in lung cancer. Methods: We systematically searched PubMed, Scopus, Web of Science and other databases through 23 March 2018. Study quality was assessed using the Quality Assessment of Diagnostic Accuracy Studies-2. We used the bivariate mixed-effect models to calculate pooled values of sensitivity, specificity, positive likelihood ratios, negative likelihood ratios, diagnostic odds ratios and associated 95% confidence intervals. Summary receiver operating characteristic (SROC) curves were used to summarize overall test performance. Deek’s funnel plot was used to detect publication bias. Results: Review of 468 candidate articles identified fifty-three articles with a total of 11,515 patients for qualitative review and meta-analysis. Pooled sensitivity, specificity and area under the SROC curve were as follows for tumor-associated autoantibodies against the following proteins: p53, 0.19, 0.98, 0.82; NY-ESO-1, 0.17, 0.98, 0.90; Survivin, 0.19, 0.99, 0.96; c-myc, 0.14, 0.98, 0.45; Cyclin B1, 0.18, 0.98, 0.91; GBU4-5, 0.07, 0.98, 0.91; CAGE, 0.14, 0.98, 0.90; p16, 0.08, 0.97, 0.91; SOX2, 0.14, 0.99, 0.93; and HuD, 0.17, 0.99, 0.82. Conclusion: Each tumor-associated autoantibody on its own showed excellent diagnostic specificity for lung cancer but inadequate sensitivity. Our results suggest that combinations or panels of tumor-associated autoantibodies may provide better sensitivity for diagnosing lung cancer, and the diagnostic accuracy of tumor-associated autoantibodies should be validated in more studies.

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Accuracy of Enzyme-Linked Immunosorbent Assays (ELISAs) in Detecting Antibodies againstMycobacterium lepraein Leprosy Patients: A Systematic Review and Meta-Analysis

Canadian Journal of Infectious Diseases and Medical Microbiology ◽

10.1155/2018/9828023 ◽

2018 ◽

Vol 2018 ◽

pp. 1-11 ◽

Cited By ~ 5

Author(s):

Omar Ariel Espinosa ◽

Silvana Margarida Benevides Ferreira ◽

Fabiana Gulin Longhi Palacio ◽

Denise da Costa Boamorte Cortela ◽

Eliane Ignotti

Keyword(s):

Diagnostic Accuracy ◽

Odds Ratio ◽

Meta Analysis ◽

Characteristic Curve ◽

Diagnostic Odds Ratio ◽

Cochrane Library ◽

Likelihood Ratios ◽

Summary Receiver Operating Characteristic ◽

Immunosorbent Assays ◽

Sensitivity Specificity

IgM againstMycobacterium lepraemay be detected by enzyme-linked immunosorbent assays (ELISAs) based on phenolic glycolipid I (PGL-I) or natural disaccharide octyl bovine serum albumin (ND-O-BSA) as antigens, and the IgG response can be detected by an ELISA based on lipid droplet protein 1 (LID-1). The titers of antibodies against these antigens vary with operational classification. The aim of this study was to compare the accuracy of ELISAs involving PGL-I and ND-O-BSA with that involving LID-1. We included studies that analyze multibacillary and paucibacillary leprosy cases and evaluate the diagnostic accuracy of ELISAs based on LID-1 and/or PGL-I or ND-O-BSA as antigens to measure antibody titers againstM. leprae. Studies were found via PubMed, the Virtual Health Library Regional Portal, Literatura Latino-Americana e do Caribe em Ciências da Saúde, Índice Bibliográfico Espanhol de Ciências de Saúde, the Brazilian Society of Dermatology, National Institute for Health and Clinical Excellence, Cochrane Library, Embase (the Elsevier database), and Cumulative Index to Nursing and Allied Health Literature. The Quality Assessment of Diagnostic Accuracy Studies served as a methodological validity tool. Quantitative data were extracted using the Standards for Reporting of Diagnostic Accuracy. Sensitivity, specificity, and a diagnostic odds ratio were calculated, and a hierarchical summary receiver-operating characteristic curve and forest plots were constructed. The protocol register code for this meta-analysis is PROSPERO 2017: CRD42017055983. Nineteen studies were included. ND-O-BSA showed better overall performance in terms of sensitivity, specificity, positive and negative likelihood ratios, and diagnostic odds ratio when compared with PGL-I and LID-1. The multibacillary group showed better performance on these parameters (than the paucibacillary group did), at 94%, 99%, 129, 0.05, and 2293, respectively. LID-1 did not provide any advantage regarding the overall estimate of sensitivity in comparison with PGL-I or ND-O-BSA.

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Diagnostic Effect of Attenuation Correction in Myocardial Perfusion Imaging in Different Coronary Arteries: A Systematic Review and Meta-Analysis

Frontiers in Cardiovascular Medicine ◽

10.3389/fcvm.2021.756060 ◽

2021 ◽

Vol 8 ◽

Author(s):

Jei-Yie Huang ◽

Chun-Kai Huang ◽

Ruoh-Fang Yen ◽

Kuo-Liong Chien ◽

Yen-Wen Wu

Keyword(s):

Coronary Artery ◽

Myocardial Perfusion Imaging ◽

Myocardial Perfusion ◽

Diagnostic Accuracy ◽

Attenuation Correction ◽

Perfusion Imaging ◽

Diagnostic Performance ◽

Meta Analysis ◽

Odds Ratios ◽

Summary Receiver Operating Characteristic

Background: The aim of this study was to determine whether, and if so how, attenuation correction (AC) improves the diagnostic performance of myocardial perfusion imaging (MPI) in different coronary artery-supplied territories, using coronary angiography as the reference standard.Methods: PubMed and EMBASE were searched until December 2020 for studies evaluating AC MPI for the diagnosis of coronary artery disease (CAD) with vessel-based data. Methodological quality was assessed using the Quality Assessment of Diagnostic Accuracy Studies tool. For each study, the sensitivity, specificity, diagnostic odds ratios and areas under summary receiver operating characteristic curves (AUC) with 95% confidence intervals were calculated to determine the diagnostic accuracy of AC compared to non-AC MPI. A bivariate mixed-effects model was used to pool the data. Subgroup analyses considering the type of radiotracer and type of AC were performed.Results: A total of 264 articles were screened, of which 22 studies (2,608 patients) were enrolled. Significant improvements in specificity [0.78 vs. 0.58 in overall CAD, 0.87 vs. 0.61 in right coronary artery (RCA)] and diagnostic odds ratios (16 vs. 8 in overall CAD, 18 vs. 7 in RCA) after AC were shown in overall CAD at a patient level and RCA stenosis. Improvements in AUC were also noted. MPI had a similar diagnostic performance for detecting left anterior descending and left circumflex coronary artery stenosis with or without AC. There were trends of decreased sensitivity after AC, but none were significant. Diagnostic odds ratio showed significant improvement after AC only in the technetium-99m subgroup.Conclusion: The results of this study suggest that AC should be applied to MPI to improve the diagnosis of CAD regardless of which type of radiotracer, and that AC MPI can improve the specificity of detecting RCA stenosis.

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Diagnostic Accuracy of the Quidel Sofia Rapid Influenza Fluorescent Immunoassay in Patients with Influenza-like illness: A Systematic Review and Meta-analysis

10.21203/rs.3.rs-97759/v1 ◽

2020 ◽

Author(s):

Jonghoo Lee ◽

Jae-Uk Song

Keyword(s):

Diagnostic Accuracy ◽

Odds Ratio ◽

Influenza A ◽

Meta Analysis ◽

Characteristic Curve ◽

Diagnostic Odds Ratio ◽

Influenza B ◽

Cochrane Central Register ◽

Summary Receiver Operating Characteristic ◽

Sensitivity Specificity

Abstract Background: Although the Quidel Sofia rapid influenza fluorescent immunoassay (FIA) is widely used to identify influenza A and B, the diagnostic accuracy of this test remains unclear. We compared the diagnostic performances of this test with reverse transcriptase-polymerase chain reaction.Methods: A systematic literature search was performed using MEDLINE, EMBASE, and the Cochrane Central Register. The sensitivity, specificity, diagnostic odds ratio (DOR), and a hierarchical summary receiver-operating characteristic curve (HSROC) of this test for identifying influenza A and B were pooled using meta-analysis. A sensitivity and subgroup analysis was used to identify potential sources of heterogeneity within the selected studies.Results: We identified seventeen studies comprising 8,334 patients. The pooled sensitivity, specificity, and DOR of the Quidel Sofia rapid influenza FIA to identify influenza A were 0.78 (95% CI, 0.71–0.83), 0.99 (95% CI, 0.98–0.99), and 251.26 (95% CI, 139.39–452.89), respectively. The pooled sensitivity, specificity, and diagnostic odds ratio of this test to identify influenza B were 0.72 (95% CI, 0.60–0.82), 0.98 (95% CI, 0.96-0.99), and 140.20 (95% CI, 55.92-351.54), respectively. The area under the HSROC for this test was similar for identification of influenza A and influenza B. Age was considered a probable source of heterogeneity.Conclusions: The pooled sensitivities of the Quidel Sofia rapid influenza FIA did not quite meet the target level (≥80%) for both influenza A and B. The interpretation of data should be carefully considered due to substantial between-study heterogeneity.

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Diagnostic accuracy of Mycobacterium tuberculosis cell-free DNA for tuberculosis: A systematic review and meta-analysis

PLoS ONE ◽

10.1371/journal.pone.0253658 ◽

2021 ◽

Vol 16 (6) ◽

pp. e0253658

Author(s):

Guocan Yu ◽

Yanqin Shen ◽

Bo Ye ◽

Yan Shi

Keyword(s):

Mycobacterium Tuberculosis ◽

Diagnostic Accuracy ◽

Predictive Value ◽

Meta Analysis ◽

False Negative ◽

Summary Receiver Operating Characteristic ◽

True Negative ◽

Cell Free Dna ◽

Free Dna ◽

Sensitivity Specificity

Background Diagnosis of tuberculosis (TB) is still difficult. The purpose of our study was to evaluate the diagnostic accuracy of Mycobacterium tuberculosis cell-free DNA (cfDNA) for diagnosing of TB. Methods We searched relevant databases for studies that used cfDNA to diagnose TB. We evaluated the accuracy of cfDNA compared with the composite reference standard (CRS) and culture. True positive, false positive, false negative, and true negative values for cfDNA were obtained first, then the estimated pooled sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), diagnostic odds ratio (DOR), and the area under the summary receiver operating characteristic (SROC) curve (AUC) of cfDNA for diagnosing TB were calculated with 95% confidence intervals (CIs). Heterogeneity was determined using the I2 statistic. When the heterogeneity was obvious, the source of heterogeneity was further discussed. Results We included 14 independent studies comparing cfDNA with the CRS, and 4 studies compared with culture. The pooled sensitivity, specificity, PPV, NPV, DOR, and AUC of the SROC were 68%, 98%,99%, 62%, 83, and 0.97 as compared with the CRS, respectively. The pooled sensitivity, specificity, PPV, NPV, DOR, and AUC of the SROC were 48%, 91%, 92%, 60%, 5, and 0.88 as compared with culture, respectively. The heterogeneity between studies was significant. Conclusions The accuracy of cfDNA testing for TB diagnosis was good compared with CRS and culture. cfDNA can be used for rapid early diagnosis of TB.

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Diagnostic Accuracy of PET for Differentiating True Glioma Progression From Post Treatment-Related Changes: A Systematic Review and Meta-Analysis

Frontiers in Neurology ◽

10.3389/fneur.2021.671867 ◽

2021 ◽

Vol 12 ◽

Author(s):

Meng Cui ◽

Rocío Isabel Zorrilla-Veloz ◽

Jian Hu ◽

Bing Guan ◽

Xiaodong Ma

Keyword(s):

Diagnostic Accuracy ◽

Fdg Pet ◽

Meta Analysis ◽

Post Treatment ◽

Low Grade ◽

Summary Receiver Operating Characteristic ◽

Fet Pet ◽

Glioma Recurrence ◽

Met Pet ◽

Glioma Progression

Purpose: To evaluate the diagnostic accuracy of PET with different radiotracers and parameters in differentiating between true glioma progression (TPR) and post treatment-related change (PTRC).Methods: Studies on using PET to differentiate between TPR and PTRC were screened from the PubMed and Embase databases. By following the PRISMA checklist, the quality assessment of included studies was performed, the true positive and negative values (TP and TN), false positive and negative values (FP and FN), and general characteristics of all the included studies were extracted. Results of PET consistent with reference standard were defined as TP or TN. The pooled sensitivity (Sen), specificity (Spe), and hierarchical summary receiver operating characteristic curves (HSROC) were generated to evaluate the diagnostic accuracy.Results: The 33 included studies had 1,734 patients with 1,811 lesions suspected of glioma recurrence. Fifteen studies tested the accuracy of 18F-FET PET, 12 tested 18F-FDG PET, seven tested 11C-MET PET, and three tested 18F-DOPA PET. 18F-FET PET showed a pooled Sen and Spe of 0.88 (95% CI: 0.80, 0.93) and 0.78 (0.69, 0.85), respectively. In the subgroup analysis of FET-PET, diagnostic accuracy of high-grade gliomas (HGGs) was higher than that of mixed-grade gliomas (Pinteraction = 0.04). 18F-FDG PET showed a pooled Sen and Spe of 0.78 (95% CI: 0.71, 0.83) and 0.87 (0.80, 0.92), the Spe of the HGGs group was lower than that of the low-grade gliomas group (0.82 vs. 0.90, P = 0.02). 11C-MET PET had a pooled Sen and Spe of 0.92 (95% CI: 0.83, 0.96) and 0.78 (0.69, 0.86). 18F-DOPA PET had a pooled Sen and Spe of 0.85 (95% CI: 0.80, 0.89) and 0.70 (0.60, 0.79). FET-PET combined with MRI had a pooled Sen and Spe of 0.88 (95% CI: 0.78, 0.94) and 0.76 (0.57, 0.88). Multi-parameters analysis of FET-PET had pooled Sen and Spe values of 0.88 (95% CI: 0.81, 0.92) and 0.79 (0.63, 0.89).Conclusion: PET has a moderate diagnostic accuracy in differentiating between TPR and PTRC. The high Sen of amino acid PET and high Spe of FDG-PET suggest that the combination of commonly used FET-PET and FDG-PET may be more accurate and promising, especially for low-grade glioma.

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The Value of Contrast-Enhanced Ultrasound (CEUS) in Differentiating Testicular Masses: A Systematic Review and Meta-Analysis

Applied Sciences ◽

10.3390/app11198990 ◽

2021 ◽

Vol 11 (19) ◽

pp. 8990

Author(s):

Antonio Tufano ◽

Rocco Simone Flammia ◽

Luca Antonelli ◽

Rocco Minelli ◽

Giorgio Franco ◽

...

Keyword(s):

Systematic Review ◽

Predictive Value ◽

Diagnostic Performance ◽

Meta Analysis ◽

Contrast Enhanced Ultrasound ◽

Summary Receiver Operating Characteristic ◽

Diagnostic Modality ◽

Contrast Enhanced ◽

Meta Analyses ◽

Sensitivity Specificity

Ultrasound (US) still represents the mainstay of scrotal imaging. However, contrast-enhanced ultrasound (CEUS) is a relatively novel, but increasingly utilized diagnostic modality. In consequence, we performed a systematic review (SR) and pooled meta-analysis to investigate the diagnostic performance of CEUS in the evaluation of testicular masses (TM). A SR up to June 2021 was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. The diagnostic performance of CEUS was evaluated basing on two different endpoints: neoplastic vs. non-neoplastic and malignant vs. benign TM. Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) from eligible studies were pooled and summary receiver operating characteristic (SROC) curves were constructed for each endpoint. Overall, six qualified studies were deemed suitable for this meta-analysis. Diagnostic performance of CEUS showed an accuracy of 0.96 in detecting neoplastic masses (sensitivity of 0.89, PPV of 0.85, specificity of 0.62, and NPV of 0.69) and an accuracy of 0.96 in detecting malignant masses (sensitivity of 0.86, PPV of 0.73, specificity of 0.87, and NPV of 0.91). Taken together, CEUS may represent a promising minimally invasive diagnostic tool for characterization of TM, since it allows clinicians to identify neoplastic lesions and exclude malignant tumor.

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