Ultrasonography, computed tomography and magnetic resonance imaging for diagnosis and determining resectability of pancreatic adenocarcinoma: a meta-analysis.
OBJECTIVE
To compare ultrasonography (US), computed tomography (CT), and magnetic resonance imaging (MRI) in the diagnosis and determination of resectability of pancreatic adenocarcinoma.


METHODS
Articles reporting US, CT, or MRI data of patients with known or suspected pancreatic adenocarcinoma and at least 20 patients verified with histopathology, surgical findings, or follow-up were included. A bivariate random effects approach was used to calculate sensitivity and specificity for diagnosis and resectability of pancreatic adenocarcinoma.


RESULTS
Sixty-eight articles fulfilled all inclusion criteria. For diagnosis, sensitivities of helical CT, conventional CT, MRI, and US were 91%, 86%, 84%, and 76% and specificities were 85%, 79%, 82%, and 75% respectively. Sensitivities for MRI and US were significantly lower compared with helical CT (P = 0.04 and P = 0.0001). For determining resectability, sensitivities of helical CT, conventional CT, MRI, and US were 81%, 82%, 82, and 83% and specificities were 82%, 76%, 78%, and 63% respectively. Specificity of US was significantly lower compared with helical CT (P = 0.011).


CONCLUSIONS
Helical CT is preferable as an imaging modality for the diagnosis and determination of resectability of pancreatic adenocarcinoma.
Bipat
Shandra
S
Department of Radiology, Academic Medical Center, 1105 AZ Amsterdam, The Netherlands. s.bipat@amc.uva.nl
Phoa
Saffire S K S
SS
van Delden
Otto M
OM
Bossuyt
Patrick M M
PM
Gouma
Dirk J
DJ
Laméris
Johan S
JS
Stoker
Jaap
J
D000230:Adenocarcinoma / Q000000981:diagnostic imaging / Q000601:surgery*; D000328:Adult; D000368:Aged; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D009367:Neoplasm Staging / Q000379:methods*; D010190:Pancreatic Neoplasms / Q000000981:diagnostic imaging / Q000601:surgery*; D010347:Patient Care Planning; D011237:Predictive Value of Tests; D011379:Prognosis; D012680:Sensitivity and Specificity; D036542:Tomography, Spiral Computed; D014463:Ultrasonography