Diagnostic Performance Of Contrast-enhanced Ultrasound For Benign And Malignant Salivary Gland Tumors:A Meta-analysis

Purpose:Clinical studies on the diagnosis of benign and malignant salivary gland tumors with contrast-enhanced ultrasound were summarized and meta-analysis was performed to evaluate the diagnostic value of contrast-enhanced ultrasound in salivary gland tumors.Methods:"Salivary Glands","Parotid Gland","Parotid Neoplasms","Sublingual Gland","Submandibular Gland","Contrast-enhanced Ultrasound"etc.were used as search words to retrieve English and Chinese literature which were published in Pub Med,the Cochrane Library,Embase,Web of science,China National Knowledge Infrastructure(CNKI),Wan Fang Database,VIP Database and Sino Med.The time range was from the establishment of the database to December 2022。We used The Quality Assessment of Diagnostic Accuracy Studies-2(QUADAS-2)to evaluate the quality of the final included articles.Basic information,true positive value(TP),false positive value(FP),false negative value(FN)and true negative value(TN)of the included studies were independently extracted by two researchers for statistical analysis.The I~2value was used to evaluate the heterogeneity of the included studies.If the heterogeneity was small,the fixed-effect model could be used to combine the effect size;If the heterogeneity was large,the factors that may lead to heterogeneity should be explored,and the random effects model should be used to combine the effect size.The statistical software used in this paper are Note Express,Review Manager 5.3,Meta-disc1.4 and STATA 16.0.Result:A total of 13 literatures which include 14 studies,were included in this meta-analysis,involving 1435 patients and a total of 1507 lesions.The sensitivity and specificity of the combined effect size were 83%(95%CI:79-87%),88%(95%CI:84%-92%),positive likelihood ratio 7.13(95%CI:5.09-9.98)and negative likelihood ratio 0.19(95%CI:0.15-0.24)and diagnostic odds ratio were 37.45(95%CI:14.32-58.47),and the area under the SROC curve AUC=0.85(95%CI:0.82-0.88).The 14studies were divided into two subgroups according to the variables that may lead to heterogeneity for meta-regression.The results showed that different countries(China/foreign),number of cases(more than 75/less than or equal to 75),type of study(prospective/retrospective),contrast agent dose(more than 2.5ml/less than or equal to2.5ml),and location of tumor(only in parotid gland/occurring in parotid gland and other salivary glands)may be contributing factors to heterogeneity.Conclusion:1.The sensitivity and specificity of CEUS in the diagnosis of benign and malignant salivary gland tumors were 83%,88%,and the area under SROC curve AUC was 0.85,indicating high diagnostic value.2.Differences in study population,number of cases,type of study,the dose of contrast agent and tumor location may be the reasons for the heterogeneity of the benign and malignant diagnostic tests for salivary gland tumors among CEUS.