title: Helical CT-enteroclysis in the detection of small-bowel tumours: a meta-analysis.
abstract: OBJECTIVE
  To perform a meta-analysis to determine sensitivity and specificity estimates of helical CT-enteroclysis in the detection of small-bowel tumours.
  
  
  METHODS
  A search for relevant articles published from January 1992 to November 2010 was performed. Study design, patient characteristics and 2 × 2 contingency tables were recorded for eligible studies. Heterogeneity was assessed with the I (2) statistic. A bivariate generalised linear random-effects model was used to summarise sensitivity and specificity estimates for small-bowel tumour detection on a per-patient basis. Sensitivity and specificity estimates were compared in different subgroups.
  
  
  RESULTS
  Twelve studies (696 patients) were eligible. The mean small-bowel tumour prevalence was 22.6 % (range 7.7-45.8 %). Inter-study heterogeneity was substantial for sensitivity (I (2) = 66.9 %; 95 % CI 28.7-88.5 %) and low for specificity (I (2) = 10.6 %; 95 % CI 0.0-55.0 %). On a per-patient basis, pooled sensitivity was 92.8 % (95 % CI 71.3-98.5 %) and pooled specificity 99.2 % (95 % CI 94.2-99.9 %) for the diagnosis of small-bowel tumour. Subgroup analysis revealed that small-bowel preparation, more than one imaging pass and large volumes (≥2 L) of enteral contrast agent did not improve tumour detection.
  
  
  CONCLUSIONS
  Our meta-analysis confirms that helical CT-enteroclysis has high degrees of sensitivity and specificity for small-bowel tumour detection. However, our findings reinforce the need for more standardised individual studies.
authors.affiliation: Department of Abdominal Imaging, Hôpital Lariboisière, Assistance Publique-Hôpitaux de Paris, 2 rue Ambroise Paré, 75475, Paris cedex 10, France. philippe.soyer@lrb.aphp.fr
authors.forename: Philippe
authors.initials: P
authors.lastname: Soyer
authors.forename: Mounir
authors.initials: M
authors.lastname: Aout
authors.forename: Christine
authors.initials: C
authors.lastname: Hoeffel
authors.forename: Eric
authors.initials: E
authors.lastname: Vicaut
authors.forename: Vinciane
authors.initials: V
authors.lastname: Placé
authors.forename: Mourad
authors.initials: M
authors.lastname: Boudiaf
mesh_terms: D003287:Contrast Media; D005260:Female; D006801:Humans; D007414:Intestinal Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology; D007421:Intestine, Small / Q000000981:diagnostic imaging* / Q000473:pathology; D008297:Male; D011856:Radiographic Image Enhancement / Q000379:methods*; D012680:Sensitivity and Specificity; D036542:Tomography, Spiral Computed / Q000379:methods*
chemical_list: D003287:Contrast Media