Contrast-Enhanced EUS for Differential Diagnosis of Pancreatic Masses: A Meta-Analysis

Background. Though methods for the diagnosis of pancreatic masses are various, such as ultrasonography (US), computed tomography (CT), endoscopic ultrasonography (EUS), and contrast-enhanced computed tomography (CE-CT), their sensitivity, specificity, and accuracy are not quite satisfying. Contrast-...

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Main Authors: Sibin Mei, Mengyu Wang, Leimin Sun
Format: Article
Language:English
Published: Wiley 2019-01-01
Series:Gastroenterology Research and Practice
Online Access:http://dx.doi.org/10.1155/2019/1670183
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author Sibin Mei
Mengyu Wang
Leimin Sun
author_facet Sibin Mei
Mengyu Wang
Leimin Sun
author_sort Sibin Mei
collection DOAJ
description Background. Though methods for the diagnosis of pancreatic masses are various, such as ultrasonography (US), computed tomography (CT), endoscopic ultrasonography (EUS), and contrast-enhanced computed tomography (CE-CT), their sensitivity, specificity, and accuracy are not quite satisfying. Contrast-enhanced endoscopic ultrasonography (CE-EUS), as a new technique, has its own unique advantages in diagnosing pancreatic disease. However, its sensitivity, specificity, and accuracy are still controversial. Objective. To evaluate the accuracy of CE-EUS for differential diagnosis between benign and malignant pancreatic mass lesions. Design. Eighteen relevant articles systemically searched from PubMed, Web of Science, Ovid, Scopus, and MEDLINE were selected. The pooled results were calculated in a fixed effects model. Main Outcome Measurement. The pooled sensitivity, specificity, positive likelihood ratio (LR), negative likelihood ratio, diagnostic odds ratio (OR), and summary receiver operating characteristic (SROC) curve. Results. The pooled sensitivity, specificity, and diagnostic odds ratio of CE-EUS for the differential diagnosis of pancreatic adenocarcinomas were 0.91 (95% confidence interval (CI), 0.89-0.93), 0.86 (95% CI, 0.83-0.89), and 69.50 (95% CI, 48.89-98.80), respectively. The SROC area under the curve was 0.9545. The subgroup analysis based on excluding the outliers showed that the heterogeneity was eliminated and the pooled sensitivity and specificity were 0.92 (95% CI, 0.90-0.93) and 0.87 (95% CI, 0.84-0.89), respectively. The SROC area under the curve was 0.9569. Conclusion. CE-EUS is a useful method to distinguish pancreatic adenocarcinoma from other pancreatic diseases. Compared with EUS elastography, it has higher specificity. However, it is still not superior to pathological diagnosis for the identification of pancreatic carcinomas.
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spelling doaj-art-465d38596df445488c4551cf672f425b2025-08-20T03:36:12ZengWileyGastroenterology Research and Practice1687-61211687-630X2019-01-01201910.1155/2019/16701831670183Contrast-Enhanced EUS for Differential Diagnosis of Pancreatic Masses: A Meta-AnalysisSibin Mei0Mengyu Wang1Leimin Sun2Department of Gastroenterology, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou 310016, ChinaDepartment of Gastroenterology, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou 310016, ChinaDepartment of Gastroenterology, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou 310016, ChinaBackground. Though methods for the diagnosis of pancreatic masses are various, such as ultrasonography (US), computed tomography (CT), endoscopic ultrasonography (EUS), and contrast-enhanced computed tomography (CE-CT), their sensitivity, specificity, and accuracy are not quite satisfying. Contrast-enhanced endoscopic ultrasonography (CE-EUS), as a new technique, has its own unique advantages in diagnosing pancreatic disease. However, its sensitivity, specificity, and accuracy are still controversial. Objective. To evaluate the accuracy of CE-EUS for differential diagnosis between benign and malignant pancreatic mass lesions. Design. Eighteen relevant articles systemically searched from PubMed, Web of Science, Ovid, Scopus, and MEDLINE were selected. The pooled results were calculated in a fixed effects model. Main Outcome Measurement. The pooled sensitivity, specificity, positive likelihood ratio (LR), negative likelihood ratio, diagnostic odds ratio (OR), and summary receiver operating characteristic (SROC) curve. Results. The pooled sensitivity, specificity, and diagnostic odds ratio of CE-EUS for the differential diagnosis of pancreatic adenocarcinomas were 0.91 (95% confidence interval (CI), 0.89-0.93), 0.86 (95% CI, 0.83-0.89), and 69.50 (95% CI, 48.89-98.80), respectively. The SROC area under the curve was 0.9545. The subgroup analysis based on excluding the outliers showed that the heterogeneity was eliminated and the pooled sensitivity and specificity were 0.92 (95% CI, 0.90-0.93) and 0.87 (95% CI, 0.84-0.89), respectively. The SROC area under the curve was 0.9569. Conclusion. CE-EUS is a useful method to distinguish pancreatic adenocarcinoma from other pancreatic diseases. Compared with EUS elastography, it has higher specificity. However, it is still not superior to pathological diagnosis for the identification of pancreatic carcinomas.http://dx.doi.org/10.1155/2019/1670183
spellingShingle Sibin Mei
Mengyu Wang
Leimin Sun
Contrast-Enhanced EUS for Differential Diagnosis of Pancreatic Masses: A Meta-Analysis
Gastroenterology Research and Practice
title Contrast-Enhanced EUS for Differential Diagnosis of Pancreatic Masses: A Meta-Analysis
title_full Contrast-Enhanced EUS for Differential Diagnosis of Pancreatic Masses: A Meta-Analysis
title_fullStr Contrast-Enhanced EUS for Differential Diagnosis of Pancreatic Masses: A Meta-Analysis
title_full_unstemmed Contrast-Enhanced EUS for Differential Diagnosis of Pancreatic Masses: A Meta-Analysis
title_short Contrast-Enhanced EUS for Differential Diagnosis of Pancreatic Masses: A Meta-Analysis
title_sort contrast enhanced eus for differential diagnosis of pancreatic masses a meta analysis
url http://dx.doi.org/10.1155/2019/1670183
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AT mengyuwang contrastenhancedeusfordifferentialdiagnosisofpancreaticmassesametaanalysis
AT leiminsun contrastenhancedeusfordifferentialdiagnosisofpancreaticmassesametaanalysis