Endorectal Ultrasonography and Pelvic Magnetic Resonance Imaging Show Similar Diagnostic Accuracy in Local Staging of Rectal Cancer: An Update Systematic Review and Meta-Analysis
Background: Endorectal Ultrasonography (EUS-ERUS) and pelvic magnetic resonance imaging (MRI) are world-wide performed for the local staging of rectal cancer (RC), but no clear consensus on their indications is present, there being literature in support of both. The aim of this meta-analysis is to g...
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MDPI AG
2021-12-01
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| Series: | Diagnostics |
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| Online Access: | https://www.mdpi.com/2075-4418/12/1/5 |
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| author | Gaetano Luglio Gianluca Pagano Francesca Paola Tropeano Eduardo Spina Rosa Maione Alessia Chini Francesco Maione Giuseppe Galloro Mariano Cesare Giglio Giovanni Domenico De Palma |
| author_facet | Gaetano Luglio Gianluca Pagano Francesca Paola Tropeano Eduardo Spina Rosa Maione Alessia Chini Francesco Maione Giuseppe Galloro Mariano Cesare Giglio Giovanni Domenico De Palma |
| author_sort | Gaetano Luglio |
| collection | DOAJ |
| description | Background: Endorectal Ultrasonography (EUS-ERUS) and pelvic magnetic resonance imaging (MRI) are world-wide performed for the local staging of rectal cancer (RC), but no clear consensus on their indications is present, there being literature in support of both. The aim of this meta-analysis is to give an update regarding the diagnostic test accuracy of ERUS and pelvic MRI about the local staging of RC. Materials and methods: A systematic literature search from November 2020 to October 2021 was performed to select studies in which head-to-head comparison between ERUS and MRI was reported for the local staging of rectal cancer. Quality and risk of bias were assessed with the QUADAS-2 tool. Our primary outcome was the T staging accuracy of ERUS and MRI for which pooled accuracy indices were calculated using a bivariable random-effects model. In addition, a hierarchical summary receiver operating characteristic curve (hSROC) was created to characterize the accuracy of ERUS and MRI for the staging of T and N parameters. The area under the hSROC curve (AUC<sub>hSROC</sub>) was determined as a measure of diagnostic accuracy. Results: Seven studies and 331 patients were included in our analysis. ERUS and MRI showed a similar accuracy for the T staging, with AUC<sub>hSROC</sub> curves of 0.91 (95% C.I., 0.89 to 0.93) and 0.87 (95% C.I., 0.84 to 0.89), respectively (<i>p</i> = 0.409). For T staging, ERUS showed a pooled sensitivity of 0.82 (95% C.I. 0.72 to 0.89) and pooled specificity of 0.91 (95% C.I. 0.77–0.96), while MRI had pooled sensitivity and specificity of 0.69 (95% C.I. 0.55–0.81) and 0.88 (95% C.I. 0.79–0.93), respectively. ERUS and MRI showed a similar accuracy in the N staging too, with AUC<sub>hSROC</sub> curves of 0.92 (95% C.I., 0.89 to 0.94) and 0.93 (95% C.I., 0.90 to 0.95), respectively (<i>p</i> = 0.389). Conclusions: In conclusion, ERUS and MRI are comparable imaging techniques for the local staging of rectal cancer. |
| first_indexed | 2024-03-10T01:39:27Z |
| format | Article |
| id | doaj.art-775c70d629a14073a5e09fc976cf84bf |
| institution | Directory Open Access Journal |
| issn | 2075-4418 |
| language | English |
| last_indexed | 2024-03-10T01:39:27Z |
| publishDate | 2021-12-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Diagnostics |
| spelling | doaj.art-775c70d629a14073a5e09fc976cf84bf2023-11-23T13:26:36ZengMDPI AGDiagnostics2075-44182021-12-01121510.3390/diagnostics12010005Endorectal Ultrasonography and Pelvic Magnetic Resonance Imaging Show Similar Diagnostic Accuracy in Local Staging of Rectal Cancer: An Update Systematic Review and Meta-AnalysisGaetano Luglio0Gianluca Pagano1Francesca Paola Tropeano2Eduardo Spina3Rosa Maione4Alessia Chini5Francesco Maione6Giuseppe Galloro7Mariano Cesare Giglio8Giovanni Domenico De Palma9Endoscopic Surgery Unit, Department of Medical and Surgical Gastrointestinal Disease, Federico II University of Naples, 80131 Naples, ItalyEndoscopic Surgery Unit, Department of Medical and Surgical Gastrointestinal Disease, Federico II University of Naples, 80131 Naples, ItalyEndoscopic Surgery Unit, Department of Medical and Surgical Gastrointestinal Disease, Federico II University of Naples, 80131 Naples, ItalyEndoscopic Surgery Unit, Department of Medical and Surgical Gastrointestinal Disease, Federico II University of Naples, 80131 Naples, ItalyEndoscopic Surgery Unit, Department of Medical and Surgical Gastrointestinal Disease, Federico II University of Naples, 80131 Naples, ItalyEndoscopic Surgery Unit, Department of Medical and Surgical Gastrointestinal Disease, Federico II University of Naples, 80131 Naples, ItalyEndoscopic Surgery Unit, Department of Medical and Surgical Gastrointestinal Disease, Federico II University of Naples, 80131 Naples, ItalyEndoscopic Surgery Unit, Department of Medical and Surgical Gastrointestinal Disease, Federico II University of Naples, 80131 Naples, ItalyDivision of HPB, Minimally Invasive and Robotic Surgery, Federico II University of Naples, 80131 Naples, ItalyEndoscopic Surgery Unit, Department of Medical and Surgical Gastrointestinal Disease, Federico II University of Naples, 80131 Naples, ItalyBackground: Endorectal Ultrasonography (EUS-ERUS) and pelvic magnetic resonance imaging (MRI) are world-wide performed for the local staging of rectal cancer (RC), but no clear consensus on their indications is present, there being literature in support of both. The aim of this meta-analysis is to give an update regarding the diagnostic test accuracy of ERUS and pelvic MRI about the local staging of RC. Materials and methods: A systematic literature search from November 2020 to October 2021 was performed to select studies in which head-to-head comparison between ERUS and MRI was reported for the local staging of rectal cancer. Quality and risk of bias were assessed with the QUADAS-2 tool. Our primary outcome was the T staging accuracy of ERUS and MRI for which pooled accuracy indices were calculated using a bivariable random-effects model. In addition, a hierarchical summary receiver operating characteristic curve (hSROC) was created to characterize the accuracy of ERUS and MRI for the staging of T and N parameters. The area under the hSROC curve (AUC<sub>hSROC</sub>) was determined as a measure of diagnostic accuracy. Results: Seven studies and 331 patients were included in our analysis. ERUS and MRI showed a similar accuracy for the T staging, with AUC<sub>hSROC</sub> curves of 0.91 (95% C.I., 0.89 to 0.93) and 0.87 (95% C.I., 0.84 to 0.89), respectively (<i>p</i> = 0.409). For T staging, ERUS showed a pooled sensitivity of 0.82 (95% C.I. 0.72 to 0.89) and pooled specificity of 0.91 (95% C.I. 0.77–0.96), while MRI had pooled sensitivity and specificity of 0.69 (95% C.I. 0.55–0.81) and 0.88 (95% C.I. 0.79–0.93), respectively. ERUS and MRI showed a similar accuracy in the N staging too, with AUC<sub>hSROC</sub> curves of 0.92 (95% C.I., 0.89 to 0.94) and 0.93 (95% C.I., 0.90 to 0.95), respectively (<i>p</i> = 0.389). Conclusions: In conclusion, ERUS and MRI are comparable imaging techniques for the local staging of rectal cancer.https://www.mdpi.com/2075-4418/12/1/5rectal cancerstagingendorectal ultrasonographypelvic magnetic resonance imaging |
| spellingShingle | Gaetano Luglio Gianluca Pagano Francesca Paola Tropeano Eduardo Spina Rosa Maione Alessia Chini Francesco Maione Giuseppe Galloro Mariano Cesare Giglio Giovanni Domenico De Palma Endorectal Ultrasonography and Pelvic Magnetic Resonance Imaging Show Similar Diagnostic Accuracy in Local Staging of Rectal Cancer: An Update Systematic Review and Meta-Analysis Diagnostics rectal cancer staging endorectal ultrasonography pelvic magnetic resonance imaging |
| title | Endorectal Ultrasonography and Pelvic Magnetic Resonance Imaging Show Similar Diagnostic Accuracy in Local Staging of Rectal Cancer: An Update Systematic Review and Meta-Analysis |
| title_full | Endorectal Ultrasonography and Pelvic Magnetic Resonance Imaging Show Similar Diagnostic Accuracy in Local Staging of Rectal Cancer: An Update Systematic Review and Meta-Analysis |
| title_fullStr | Endorectal Ultrasonography and Pelvic Magnetic Resonance Imaging Show Similar Diagnostic Accuracy in Local Staging of Rectal Cancer: An Update Systematic Review and Meta-Analysis |
| title_full_unstemmed | Endorectal Ultrasonography and Pelvic Magnetic Resonance Imaging Show Similar Diagnostic Accuracy in Local Staging of Rectal Cancer: An Update Systematic Review and Meta-Analysis |
| title_short | Endorectal Ultrasonography and Pelvic Magnetic Resonance Imaging Show Similar Diagnostic Accuracy in Local Staging of Rectal Cancer: An Update Systematic Review and Meta-Analysis |
| title_sort | endorectal ultrasonography and pelvic magnetic resonance imaging show similar diagnostic accuracy in local staging of rectal cancer an update systematic review and meta analysis |
| topic | rectal cancer staging endorectal ultrasonography pelvic magnetic resonance imaging |
| url | https://www.mdpi.com/2075-4418/12/1/5 |
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