“…A meta-analysis of 8 RTE studies performed between 2005 and 2009 (639 thyroid nodules, 24% malignancies) calculated a pooled sensitivity and specificity of 92% and 90%, respectively [ 16 , 25 , 27 , 30 , 35 , 42 , 44 , 48 , 59 ] . Many reports suggest that RTE is an independent predictor for malignancy, with accuracy results exceeding conventional US criteria [ 17 , 23 , 31 , 33 , 36 , 39 , 46 , 47 , 49 , 54 , 55 ] . For example, Cantisani et al [ 23 ] documented much higher SRs in malignant compared with benign nodules (7.3 ± 4.3 vs. 1.2 ± 0.7), and an SR cut-off ≥2 achieved 97.3% sensitivity, 91.7% specificity, 87.8% positive predictive value (PPV), 98.2% negative predictive value (NPV) and 93.8% accuracy.…”