Contrast-enhanced ultrasound and contrast-enhanced computed tomography for differentiating mass-forming pancreatitis from pancreatic ductal adenocarcinoma: a meta-analysis

Abstract. Background:. Patients with mass-forming pancreatitis (MFP) or pancreatic ductal adenocarcinoma (PDAC) presented similar clinical symptoms, but required different treatment approaches and had different survival outcomes. This meta-analysis aimed to compare the diagnostic performance of cont...

Full description

Bibliographic Details
Main Authors: Jie Yang, Jiayan Huang, Yonggang Zhang, Keyu Zeng, Min Liao, Zhenpeng Jiang, Wuyongga Bao, Qiang Lu, Lishao Guo
Format: Article
Language:English
Published: Wolters Kluwer 2023-09-01
Series:Chinese Medical Journal
Online Access:http://journals.lww.com/10.1097/CM9.0000000000002300
_version_ 1797729152597491712
author Jie Yang
Jiayan Huang
Yonggang Zhang
Keyu Zeng
Min Liao
Zhenpeng Jiang
Wuyongga Bao
Qiang Lu
Lishao Guo
author_facet Jie Yang
Jiayan Huang
Yonggang Zhang
Keyu Zeng
Min Liao
Zhenpeng Jiang
Wuyongga Bao
Qiang Lu
Lishao Guo
author_sort Jie Yang
collection DOAJ
description Abstract. Background:. Patients with mass-forming pancreatitis (MFP) or pancreatic ductal adenocarcinoma (PDAC) presented similar clinical symptoms, but required different treatment approaches and had different survival outcomes. This meta-analysis aimed to compare the diagnostic performance of contrast-enhanced ultrasound (CEUS) and contrast-enhanced computed tomography (CECT) in differentiating MFP from PDAC. Methods:. A literature search was performed in the PubMed, EMBASE (Ovid), Cochrane Library (CENTRAL), China National Knowledge Infrastructure (CNKI), Weipu (VIP), and WanFang databases to identify original studies published from inception to August 20, 2021. Studies reporting the diagnostic performances of CEUS and CECT for differentiating MFP from PDAC were included. The meta-analysis was performed with Stata 15.0 software. The outcomes included the pooled sensitivity, specificity, positive likelihood ratio (+LR), negative likelihood ratio (−LR), diagnostic odds ratio (DOR), and summary receiver operating characteristic (SROC) curves of CEUS and CECT. Meta-regression was conducted to investigate heterogeneity. Bayesian network meta-analysis was conducted to indirectly compare the overall diagnostic performance. Results:. Twenty-six studies with 2115 pancreatic masses were included. The pooled sensitivity and specificity of CEUS for MFP were 82% (95% confidence interval [CI], 73%–88%; I2 = 0.00%) and 95% (95% CI, 90%–97%; I2 = 63.44%), respectively; the overall +LR, −LR, and DOR values were 15.12 (95% CI, 7.61–30.01), 0.19 (95% CI, 0.13–0.29), and 78.91 (95% CI, 30.94–201.27), respectively; and the area under the SROC curve (AUC) was 0.90 (95% CI, 0.87–92). However, the overall sensitivity and specificity of CECT were 81% (95% CI, 75–85%; I2 = 66.37%) and 94% (95% CI, 90–96%; I2 = 74.87%); the overall +LR, −LR, and DOR values were 12.91 (95% CI, 7.86–21.20), 0.21 (95% CI, 0.16–0.27), and 62.53 (95% CI, 34.45–113.51), respectively; and, the SROC AUC was 0.92 (95% CI, 0.90–0.94). The overall diagnostic accuracy of CEUS was comparable to that of CECT for the differential diagnosis of MFP and PDAC (relative DOR 1.26, 95% CI [0.42–3.83], P > 0.05). Conclusions:. CEUS and CECT have comparable diagnostic performance for differentiating MFP from PDAC, and should be considered as mutually complementary diagnostic tools for suspected focal pancreatic lesions.
first_indexed 2024-03-12T11:24:54Z
format Article
id doaj.art-29c03474668f422588cb589b0ec47735
institution Directory Open Access Journal
issn 0366-6999
2542-5641
language English
last_indexed 2024-03-12T11:24:54Z
publishDate 2023-09-01
publisher Wolters Kluwer
record_format Article
series Chinese Medical Journal
spelling doaj.art-29c03474668f422588cb589b0ec477352023-09-01T09:41:51ZengWolters KluwerChinese Medical Journal0366-69992542-56412023-09-01136172028203610.1097/CM9.0000000000002300202309050-00002Contrast-enhanced ultrasound and contrast-enhanced computed tomography for differentiating mass-forming pancreatitis from pancreatic ductal adenocarcinoma: a meta-analysisJie YangJiayan HuangYonggang ZhangKeyu ZengMin LiaoZhenpeng JiangWuyongga BaoQiang LuLishao GuoAbstract. Background:. Patients with mass-forming pancreatitis (MFP) or pancreatic ductal adenocarcinoma (PDAC) presented similar clinical symptoms, but required different treatment approaches and had different survival outcomes. This meta-analysis aimed to compare the diagnostic performance of contrast-enhanced ultrasound (CEUS) and contrast-enhanced computed tomography (CECT) in differentiating MFP from PDAC. Methods:. A literature search was performed in the PubMed, EMBASE (Ovid), Cochrane Library (CENTRAL), China National Knowledge Infrastructure (CNKI), Weipu (VIP), and WanFang databases to identify original studies published from inception to August 20, 2021. Studies reporting the diagnostic performances of CEUS and CECT for differentiating MFP from PDAC were included. The meta-analysis was performed with Stata 15.0 software. The outcomes included the pooled sensitivity, specificity, positive likelihood ratio (+LR), negative likelihood ratio (−LR), diagnostic odds ratio (DOR), and summary receiver operating characteristic (SROC) curves of CEUS and CECT. Meta-regression was conducted to investigate heterogeneity. Bayesian network meta-analysis was conducted to indirectly compare the overall diagnostic performance. Results:. Twenty-six studies with 2115 pancreatic masses were included. The pooled sensitivity and specificity of CEUS for MFP were 82% (95% confidence interval [CI], 73%–88%; I2 = 0.00%) and 95% (95% CI, 90%–97%; I2 = 63.44%), respectively; the overall +LR, −LR, and DOR values were 15.12 (95% CI, 7.61–30.01), 0.19 (95% CI, 0.13–0.29), and 78.91 (95% CI, 30.94–201.27), respectively; and the area under the SROC curve (AUC) was 0.90 (95% CI, 0.87–92). However, the overall sensitivity and specificity of CECT were 81% (95% CI, 75–85%; I2 = 66.37%) and 94% (95% CI, 90–96%; I2 = 74.87%); the overall +LR, −LR, and DOR values were 12.91 (95% CI, 7.86–21.20), 0.21 (95% CI, 0.16–0.27), and 62.53 (95% CI, 34.45–113.51), respectively; and, the SROC AUC was 0.92 (95% CI, 0.90–0.94). The overall diagnostic accuracy of CEUS was comparable to that of CECT for the differential diagnosis of MFP and PDAC (relative DOR 1.26, 95% CI [0.42–3.83], P > 0.05). Conclusions:. CEUS and CECT have comparable diagnostic performance for differentiating MFP from PDAC, and should be considered as mutually complementary diagnostic tools for suspected focal pancreatic lesions.http://journals.lww.com/10.1097/CM9.0000000000002300
spellingShingle Jie Yang
Jiayan Huang
Yonggang Zhang
Keyu Zeng
Min Liao
Zhenpeng Jiang
Wuyongga Bao
Qiang Lu
Lishao Guo
Contrast-enhanced ultrasound and contrast-enhanced computed tomography for differentiating mass-forming pancreatitis from pancreatic ductal adenocarcinoma: a meta-analysis
Chinese Medical Journal
title Contrast-enhanced ultrasound and contrast-enhanced computed tomography for differentiating mass-forming pancreatitis from pancreatic ductal adenocarcinoma: a meta-analysis
title_full Contrast-enhanced ultrasound and contrast-enhanced computed tomography for differentiating mass-forming pancreatitis from pancreatic ductal adenocarcinoma: a meta-analysis
title_fullStr Contrast-enhanced ultrasound and contrast-enhanced computed tomography for differentiating mass-forming pancreatitis from pancreatic ductal adenocarcinoma: a meta-analysis
title_full_unstemmed Contrast-enhanced ultrasound and contrast-enhanced computed tomography for differentiating mass-forming pancreatitis from pancreatic ductal adenocarcinoma: a meta-analysis
title_short Contrast-enhanced ultrasound and contrast-enhanced computed tomography for differentiating mass-forming pancreatitis from pancreatic ductal adenocarcinoma: a meta-analysis
title_sort contrast enhanced ultrasound and contrast enhanced computed tomography for differentiating mass forming pancreatitis from pancreatic ductal adenocarcinoma a meta analysis
url http://journals.lww.com/10.1097/CM9.0000000000002300
work_keys_str_mv AT jieyang contrastenhancedultrasoundandcontrastenhancedcomputedtomographyfordifferentiatingmassformingpancreatitisfrompancreaticductaladenocarcinomaametaanalysis
AT jiayanhuang contrastenhancedultrasoundandcontrastenhancedcomputedtomographyfordifferentiatingmassformingpancreatitisfrompancreaticductaladenocarcinomaametaanalysis
AT yonggangzhang contrastenhancedultrasoundandcontrastenhancedcomputedtomographyfordifferentiatingmassformingpancreatitisfrompancreaticductaladenocarcinomaametaanalysis
AT keyuzeng contrastenhancedultrasoundandcontrastenhancedcomputedtomographyfordifferentiatingmassformingpancreatitisfrompancreaticductaladenocarcinomaametaanalysis
AT minliao contrastenhancedultrasoundandcontrastenhancedcomputedtomographyfordifferentiatingmassformingpancreatitisfrompancreaticductaladenocarcinomaametaanalysis
AT zhenpengjiang contrastenhancedultrasoundandcontrastenhancedcomputedtomographyfordifferentiatingmassformingpancreatitisfrompancreaticductaladenocarcinomaametaanalysis
AT wuyonggabao contrastenhancedultrasoundandcontrastenhancedcomputedtomographyfordifferentiatingmassformingpancreatitisfrompancreaticductaladenocarcinomaametaanalysis
AT qianglu contrastenhancedultrasoundandcontrastenhancedcomputedtomographyfordifferentiatingmassformingpancreatitisfrompancreaticductaladenocarcinomaametaanalysis
AT lishaoguo contrastenhancedultrasoundandcontrastenhancedcomputedtomographyfordifferentiatingmassformingpancreatitisfrompancreaticductaladenocarcinomaametaanalysis