Contrast-enhanced EUS for differential diagnosis of pancreatic mass lesions: a meta-analysis.
BACKGROUND
Distinguishing pancreatic adenocarcinomas from other pancreatic masses remains challenging with current imaging techniques. Contrast-enhanced EUS further improved the efficacy of EUS to characterize pancreatic lesions.


OBJECTIVE
To assess the accuracy of contrast-enhanced EUS for diagnosing adenocarcinoma in patients with pancreatic masses by pooling data of existing trials.


METHODS
We systematically searched the Medline, PubMed, Web of Science, Embase, and Cochrane Central Trials databases for relevant studies published. Meta-analysis was performed. Pooling was conducted in a fixed-effect model or a random-effects model.


METHODS
Twelve studies involving 1139 patients were included.


METHODS
Contrast-enhanced EUS.


METHODS
Meta-analysis and meta-regression analysis.


RESULTS
The pooled sensitivity of contrast-enhanced EUS for the differential diagnosis of pancreatic adenocarcinomas was 94% (95% CI, 0.91-0.95), and the specificity was 89% (95% CI, 0.85-0.92). The area under the curve under summary receiver operating characteristic was 0.9732. The pooled positive likelihood ratio was 8.09 (95% CI, 4.47-14.64), and the negative likelihood ratio was 0.08 (95% CI, 0.06-0.10). The subgroup analysis by exclusion of the outliers provided a sensitivity of 93% (95% CI, 0.91-0.95) and a specificity of 93% (95% CI, 0.89-0.95) for the differential diagnosis of pancreatic adenocarcinomas. The area under the curve under summary receiver operating characteristic was 0.9745.


CONCLUSIONS
A small number of studies met the inclusion criteria.


CONCLUSIONS
Contrast-enhanced EUS is a promising, reliable modality for the differential diagnosis of pancreatic adenocarcinoma in patients with pancreatic mass lesions. The finding of a hypoenhanced lesion was a sensitive and accurate predictor of pancreatic adenocarcinomas. It seems to be a useful tool in clinical practice.
Department of Gastroenterology, Rui Jin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Ting-ting
TT
Gong
Duan-min
DM
Hu
Qi
Q
Zhu
D000230:Adenocarcinoma / Q000000981:diagnostic imaging*; D003287:Contrast Media; D003937:Diagnosis, Differential; D019160:Endosonography / Q000379:methods*; D006801:Humans; D015233:Models, Statistical; D010190:Pancreatic Neoplasms / Q000000981:diagnostic imaging*; D012044:Regression Analysis; D012680:Sensitivity and Specificity
D003287:Contrast Media