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CC BY-NC-ND 4.0 · Endosc Int Open 2022; 10(04): E369-E377
DOI: 10.1055/a-1782-5033
Review

Comparison of endoscopic ultrasonography with and without contrast enhancement for characterization of pancreatic tumors: a meta-analysis

Yasunobu Yamashita
1   Second Department of Internal Medicine, Wakayama Medical University, Wakayama, Japan
,
Toshio Shimokawa
2   Clinical Study Support Center, Wakayama Medical University Hospital, Wakayama, Japan
,
Reiko Ashida
1   Second Department of Internal Medicine, Wakayama Medical University, Wakayama, Japan
,
Bertrand Napoléon
3   Department of Gastroenterology, Jean Mermoz Private Hospital, Ramsay Générale de Santé, Lyon, France
,
Andrea Lisotti
4   University of Bologna/Hospital of Imola, Imola, Italy
,
Pietro Fusaroli
4   University of Bologna/Hospital of Imola, Imola, Italy
,
Rodica Gincul
3   Department of Gastroenterology, Jean Mermoz Private Hospital, Ramsay Générale de Santé, Lyon, France
,
Christoph F. Dietrich
5   Department of Internal Medicine (DAIM), Hirslanden Kliniken Beau Site, Salem und Permanence Bern, Switzerland
,
Shunsuke Omoto
6   Department of Gastroenterology and Hepatology, Kindai University Faculty of Medicine, Osaka-Sayama, Japan
,
Masayuki Kitano
1   Second Department of Internal Medicine, Wakayama Medical University, Wakayama, Japan
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Abstract

Background and study aims Endoscopic ultrasonography (EUS) is a reliable and efficient modality for detecting pancreatic tumors; however, plain EUS (P-EUS) is limited with respect to characterization of pancreatic tumors. Recently, the use of contrast-enhanced harmonic EUS (CH-EUS) has increased, and its utility for characterization of pancreatic tumors has been reported. This meta-analysis compares the diagnostic ability of P-EUS with that of CH-EUS for characterization of pancreatic tumors.

Methods A systematic meta-analysis of all potentially relevant articles in PubMed, the Cochrane library, and Google Scholar databases was performed. Fixed effects or random effects models were used to investigate pooled sensitivity, specificity, positive likelihood ratio, and negative likelihood ratio, with 95 % confidence intervals (CIs).

Results This meta-analysis included 719 patients who underwent CH-EUS and 723 who underwent P-EUS, from six eligible studies. The pooled estimates of sensitivity, specificity, and diagnostic odds ratio were 93 % (95 % CI, 0.90–0.95), 80 % (95 % CI, 0.75–0.85), and 57.9 (95 % CI, 25.9–130), respectively, for CH-EUS, and 86 % (95 % CI, 0.82–0.89), 59 % (95 % CI, 0.52–0.65), and 8.3 (95 % CI, 2.8–24.5) for P-EUS. The areas under the summary receiver operating characteristics curves for CH-EUS and P-EUS were 0.96 and 0.80, respectively. The diagnostic odds ratio for pancreatic cancer was 2.98 times higher on CH-EUS than on P-EUS (P = 0.03). Funnel plots demonstrated no publication bias.

Conclusions This meta-analysis demonstrates that CH-EUS has higher diagnostic accuracy for pancreatic cancer than P-EUS, and is thus a valuable tool for characterization of pancreatic tumors.

Supplementary material



Publikationsverlauf

Eingereicht: 08. Mai 2021

Angenommen nach Revision: 27. September 2021

Accepted Manuscript online:
25. Februar 2022

Artikel online veröffentlicht:
14. April 2022

© 2022. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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