title: Diagnostic value of EUS elastography in differentiation of benign and malignant solid pancreatic masses: a meta-analysis.
abstract: OBJECTIVE
  EUS elastography is a novel technique that can be used for distinguishing benign from malignant lymph nodes and focal pancreatic masses. However, the studies pertaining to EUS elastography for differential diagnosis of solid pancreatic masses have reported widely varied sensitivities and specificities. A meta-analysis of all relevant articles was performed to estimate the overall diagnostic accuracy of EUS elastography for differentiating benign and malignant solid pancreatic masses.
  
  
  METHODS
  The literatures were identified by searching in PubMed and Embase databases. Two reviewers independently extracted the information from the literatures for constructing 2 × 2 table. A random-effect model or a fixed-effect model was used to estimate the sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, and diagnostic odds ratio. A summary receiver operating characteristic curve (SROC) also was constructed. Meta-regression and subgroup analysis were used to explore the sources of heterogeneity.
  
  
  RESULTS
  13 studies including a total of 1042 patients with solid pancreatic masses were selected for meta-analysis. The pooled sensitivity and specificity of EUS elastography for differentiating benign and malignant solid pancreatic masses were 95% (95% confidence interval [CI], 93%-96%), 69% (95% CI, 63%-75%), respectively. The area under SROC (AUC) was 0.8695. Two significant variables were associated with heterogeneity: color pattern and blinding.
  
  
  CONCLUSIONS
  As a less invasive modality, EUS elastography is a promising method for differentiating benign and malignant solid pancreatic masses with a high sensitivity, and it can prove to be a valuable supplement to EUS-FNA.
authors.affiliation: Department of Gastroenterology, Renmin Hospital of Wuhan University, Wuhan, China.
authors.forename: Qingshan
authors.initials: Q
authors.lastname: Pei
authors.forename: Xiaoping
authors.initials: X
authors.lastname: Zou
authors.forename: Xiaoqi
authors.initials: X
authors.lastname: Zhang
authors.forename: Min
authors.initials: M
authors.lastname: Chen
authors.forename: Yi
authors.initials: Y
authors.lastname: Guo
authors.forename: Hesheng
authors.initials: H
authors.lastname: Luo
mesh_terms: D044963:Biopsy, Fine-Needle / Q000379:methods; D054459:Elasticity Imaging Techniques / Q000379:methods*; D019160:Endosonography / Q000379:methods*; D006801:Humans; D008198:Lymph Nodes / Q000000981:diagnostic imaging; D010179:Pancreas / Q000000981:diagnostic imaging* / Q000473:pathology; D010190:Pancreatic Neoplasms / Q000175:diagnosis / Q000000981:diagnostic imaging*; D012372:ROC Curve; D012680:Sensitivity and Specificity