Endoscopic Ultrasound Elastography for Differential Diagnosis of Pancreatic Masses: A Meta-Analysis

Background Distinguishing malignant from benign pancreatic tumors is challenging with current imaging techniques. Endoscopic ultrasound (EUS) elastography has further improved the efficacy of EUS for characterizing pancreatic lesions. Aims To assess, by combining data from existing trials, the accur...

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Bibliographic Details
Published in:Digestive diseases and sciences 2013-04, Vol.58 (4), p.1125-1131
Main Authors: Hu, Duan-min, Gong, Ting-ting, Zhu, Qi
Format: Article
Language:English
Subjects:
Biochemistry
Diagnosis, Differential
Elasticity Imaging Techniques
Endoscopic ultrasonography
Endoscopy
Endosonography
Gastroenterology
Hepatology
Humans
Medical research
Medicine
Medicine & Public Health
Medicine, Experimental
Oncology
Original Article
Pancreatic cancer
Pancreatic Neoplasms - diagnostic imaging
Publication Bias
Transplant Surgery
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Summary:Background Distinguishing malignant from benign pancreatic tumors is challenging with current imaging techniques. Endoscopic ultrasound (EUS) elastography has further improved the efficacy of EUS for characterizing pancreatic lesions. Aims To assess, by combining data from existing trials, the accuracy of EUS elastography in diagnosing malignant tumors for patients with pancreatic masses. Methods All relevant studies published were identified by systematic searching of databases. A meta-analysis was performed using a random-effects model to combine study results. Results Seven studies involving 752 patients were included. The sensitivity of EUS elastography for differential diagnosis of solid pancreatic masses was 97 % (95 % CI, 0.95–0.98), and the specificity was 76 % (95 % CI, 0.69–0.82). The area under the curve under summary receiver operating characteristic (SROC) was 0.9529. The combined positive likelihood ratio was 3.71 (95 % CI, 2.72–5.07), and the negative likelihood ratio was 0.05 (95 % CI, 0.02–0.13). Conclusion Our meta-analysis shows that EUS elastography is a useful tool for differential diagnosis of solid pancreatic neoplasms with very high sensitivity and relatively low specificity. The results indicate that EUS elastography not only provides information complementary to that from EUS but also potentially increases the yield of fine needle aspiration and reduces the number of unnecessary biopsies.
ISSN:0163-2116
1573-2568
DOI:10.1007/s10620-012-2428-5