Diagnostic value of ultrasound combined with computed tomography in papillary thyroid carcinoma and cervical lymph node metastasis: A meta-analysis

This study aimed to systematically evaluate the utility of ultrasound (US) plus computed tomography (CT) in diagnosing cervical lymph node metastasis (LNM) in papillary thyroid carcinoma (PTC) through meta-analysis, to explore whether combined examination can improve diagnostic efficacy compared with a single examination. Computer-based searches were conducted in PubMed, Embase, Cochrane Library, Web of Science, CNKI, Wanfang, and VIP database to collect diagnostic trials on US plus CT for PTC and cervical LNM, with search spanning from the inception of the database up to August 2025. Two personnel separately executed literature screening and extraction of data, patient characteristics, diagnostic thresholds, true positive (TP), false positive (FP), false negative (FN), and true negative (TN). The QUADAS-2 scale was employed. RevMan 5.4 and Stata 18.0 software were used for meta-analysis to combine sensitivity (SEN), specificity (SPE), positive likelihood ratio (PLR), negative likelihood ratio (NLR), and diagnostic odds ratio (DOR). Summary receiver operating characteristic (SROC) curves were generated, and the area under the curve (AUC) was determined. A total of 15 studies were included, involving 7902 PTC patients. The results showed that the combined SEN for primary cervical LNM in PTC was 0.78 (0.58–0.90), the combined SPE was 0.75 (95% CI: 0.65–0.83), the DOR was 11 (5–24), and the AUC of the SROC curve was 0.82 (0.78–0.85); For central LNM, the combined SEN was 0.77 (0.69–0.83), the SPE was 0.68 (0.53–0.80), and the AUC was 0.80 (0.76–0.83); For lateral LNM, the combined SEN was 0.83 (0.73–0.90), the SPE was 0.92 (0.85–0.96), and the AUC was 0.94 (0.92–0.96). US plus CT could noticeably improve the diagnostic efficacy of cervical LNM in PTC, especially with high SEN in detecting lateral LNM, providing an important reference for preoperative assessment and surgical plan formulation.