Endoscopic ultrasonography elastography for differential diagnosis of benign and malignant solid pancreatic masses: A systemic review and Meta-analysis

Aim: The accuracy for endoscopic ultrasonography-elastography (EUS-EG) in the evaluation of solid pancreatic masses varies greatly and the pooled results have not been updated since 2013. Also, there still lack a comprehensive comparison among EUS-EG, contrast-enhanced EUS (CE-EUS), and EUS-guided fine needle aspiration (EUS-FNA).Material and methods: A thorough search was made for diagnostic trials investigating the role of EUS-EG in solid pancreatic masses. Meta-Disc was used to calculate the pooled sensitivity, specificity, diagnostic odds ratio and summary receiver operator characteristics. Results: Finally, 17 studies (1537 patients, 1544 lesions) were selected. The pooled sensitivity and specificity for qualitative methods were 0.97 (95%CI, 0.95-0.99) and 0.67 (95%CI, 0.59-0.74), respectively; the pooled sensitivity and specificity for strain histograms were 0.97 (95%CI, 0.95-0.98) and 0.67(95%CI, 0.61-0.73), respectively; the pooled sensitivity and specificity for strain ratio were 0.98 (95%CI, 0.96-0.99) and 0.62 (95%CI, 0.56-0.68), respectively; the pooled sensitivity and specificity for CE-EUS were 0.90 (95%CI, 0.83-0.95) and 0.76 (95%CI, 0.67-0.84), respectively; the pooled sensitivity and specificity for EUS-FNA were 0.84 (95%CI, 0.77-0.90) and 0.96(95%CI, 0.88-1.00), respectively. Conclusion: EUS-EG is reliable for distinguishing solid pancreatic masses; the sensitivity and specificity for different diagnostic methods were very close. Both EUS-EG and CE-EUS can be valuable complementary supplements for EUS-FNA.

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Contrast-Enhanced EUS for Differential Diagnosis of Pancreatic Masses: A Meta-Analysis

Gastroenterology Research and Practice ◽

10.1155/2019/1670183 ◽

2019 ◽

Vol 2019 ◽

pp. 1-9 ◽

Cited By ~ 2

Author(s):

Sibin Mei ◽

Mengyu Wang ◽

Leimin Sun

Keyword(s):

Computed Tomography ◽

Differential Diagnosis ◽

Likelihood Ratio ◽

Endoscopic Ultrasonography ◽

Odds Ratio ◽

Area Under The Curve ◽

Diagnostic Odds Ratio ◽

Contrast Enhanced ◽

Pancreatic Masses ◽

Sensitivity Specificity

Background. Though methods for the diagnosis of pancreatic masses are various, such as ultrasonography (US), computed tomography (CT), endoscopic ultrasonography (EUS), and contrast-enhanced computed tomography (CE-CT), their sensitivity, specificity, and accuracy are not quite satisfying. Contrast-enhanced endoscopic ultrasonography (CE-EUS), as a new technique, has its own unique advantages in diagnosing pancreatic disease. However, its sensitivity, specificity, and accuracy are still controversial. Objective. To evaluate the accuracy of CE-EUS for differential diagnosis between benign and malignant pancreatic mass lesions. Design. Eighteen relevant articles systemically searched from PubMed, Web of Science, Ovid, Scopus, and MEDLINE were selected. The pooled results were calculated in a fixed effects model. Main Outcome Measurement. The pooled sensitivity, specificity, positive likelihood ratio (LR), negative likelihood ratio, diagnostic odds ratio (OR), and summary receiver operating characteristic (SROC) curve. Results. The pooled sensitivity, specificity, and diagnostic odds ratio of CE-EUS for the differential diagnosis of pancreatic adenocarcinomas were 0.91 (95% confidence interval (CI), 0.89-0.93), 0.86 (95% CI, 0.83-0.89), and 69.50 (95% CI, 48.89-98.80), respectively. The SROC area under the curve was 0.9545. The subgroup analysis based on excluding the outliers showed that the heterogeneity was eliminated and the pooled sensitivity and specificity were 0.92 (95% CI, 0.90-0.93) and 0.87 (95% CI, 0.84-0.89), respectively. The SROC area under the curve was 0.9569. Conclusion. CE-EUS is a useful method to distinguish pancreatic adenocarcinoma from other pancreatic diseases. Compared with EUS elastography, it has higher specificity. However, it is still not superior to pathological diagnosis for the identification of pancreatic carcinomas.

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Differential Diagnostics Focal Pancreatics Masses Based on the Analysis of the Echographic Texture of Endosonograms Using Fuzzy Mathematical Models

Journal of oncology: diagnostic radiology and radiotherapy ◽

10.37174/2587-7593-2021-4-3-64-73 ◽

2021 ◽

Vol 4 (3) ◽

pp. 64-73

Author(s):

V. A. Belozerov ◽

O. I. Ohotnikov ◽

N. A. Korenevskij ◽

S. N. Grigorev

Keyword(s):

Differential Diagnosis ◽

Mathematical Models ◽

Hybrid Model ◽

Endoscopic Ultrasonography ◽

Statistical Tests ◽

Decision Rules ◽

Ductal Adenocarcinoma ◽

Differential Diagnostics ◽

Pancreatic Masses ◽

Adenocarcinoma Of The Pancreas

Relevance: Differential diagnosis of focal formations of the pancreas is particularly difficult due to the similarity of their echosemiotics. One of the ways to objectify and improve the accuracy of ultrasound data is to use artificial intelligence methods to interpret images.Purpose: Improving the quality of diagnosis of focal pancreatic pathology according to endoscopic ultrasonography based on the analysis of the echographic texture using fuzzy mathematical models.Material and methods: In the Kursk Regional Clinical Hospital, endoscopic ultrasonography was performed in 272 patients for pancreaticobiliary diseases. The endoscopic video system of the company Olympus EVIS EXERA II with the ultrasonic processor EU-ME1 was used. Solid tumors of the pancreas were detected in 109 (40.1 %) patients, focal pancreatic masses were diagnosed in 40 (14.7 %) patients. Based on the research results, the main types of reference endosonograms corresponding to differentiable pathology were identified. On the basis of endosonograms, using hybrid fuzzy mathematical decision rul, a fuzzy hybrid model of differential diagnosis of chronic focal pancreatitis and ductal adenocarcinoma of the pancreas was obtained.Results: The selected source of information and the method of synthesis of hybrid fuzzy decision rules made it possible to obtain a fuzzy hybrid model of differential diagnosis of chronic focal pancreatitis and ductal adenocarcinoma of the pancreas. Based on the results of mathematical modeling and statistical tests on representative control samples, it was shown that the resulting model of differential diagnosis, using reference endosonograms reflecting the echographic texture of focal pancreatic masses, provides confidence in the desired diagnosis at the level of 0.6. The additional information used in the analysis of endosonograms increases the diagnostic confidence to a value of 0.9.Conclusions: The resulting model of differential diagnosis of chronic focal pancreatitis and ductal adenocarcinoma of the pancreas provides confidence in decision-making no worse than 0.9, which is an acceptable quality indicator in clinical practice in conditions of insufficient statistics with poorly formalized data structure.

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Faculty Opinions recommendation of Endoscopic ultrasound elastography for differential diagnosis of pancreatic masses: a meta-analysis.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.717976273.793472609 ◽

2013 ◽

Author(s):

Matthew DiMagno ◽

Erik Wamsteker

Keyword(s):

Differential Diagnosis ◽

Endoscopic Ultrasound ◽

Meta Analysis ◽

Ultrasound Elastography ◽

Pancreatic Masses

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Endoscopic Ultrasound Elastography for Differential Diagnosis of Pancreatic Masses: A Meta-Analysis

Digestive Diseases and Sciences ◽

10.1007/s10620-012-2428-5 ◽

2013 ◽

Vol 58 (4) ◽

pp. 1125-1131 ◽

Cited By ~ 26

Author(s):

Duan-min Hu ◽

Ting-ting Gong ◽

Qi Zhu

Keyword(s):

Differential Diagnosis ◽

Endoscopic Ultrasound ◽

Meta Analysis ◽

Ultrasound Elastography ◽

Pancreatic Masses

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Endoscopic ultrasonography with fine-needle aspiration for histological diagnosis of solid pancreatic masses: a meta-analysis of diagnostic accuracy studies

BMC Gastroenterology ◽

10.1186/s12876-016-0519-z ◽

2016 ◽

Vol 16 (1) ◽

Cited By ~ 34

Author(s):

Omar Banafea ◽

Fabian Pius Mghanga ◽

Jinfang Zhao ◽

Ruifeng Zhao ◽

Liangru Zhu

Keyword(s):

Diagnostic Accuracy ◽

Endoscopic Ultrasonography ◽

Fine Needle Aspiration ◽

Meta Analysis ◽

Needle Aspiration ◽

Histological Diagnosis ◽

Fine Needle ◽

Pancreatic Masses

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Telomerase Activity as a Marker for Differential Diagnosis of Pancreatic Adenocarcinoma: A Systematic Review and Meta-Analysis

The International Journal of Biological Markers ◽

10.5301/jbm.5000172 ◽

2016 ◽

Vol 31 (2) ◽

pp. 126-137 ◽

Cited By ~ 1

Author(s):

Huajian Gu ◽

Xiaoyan Xin ◽

Yaozhen Pan ◽

Hong Zhang ◽

She Tian ◽

...

Keyword(s):

Differential Diagnosis ◽

Pancreatic Adenocarcinoma ◽

Sensitivity And Specificity ◽

Meta Analysis ◽

Diagnostic Odds Ratio ◽

Telomerase Activity ◽

Systemic Review ◽

Summary Receiver Operating Characteristic ◽

Pancreatic Diseases ◽

Comprehensive Search

Background Studies evaluating the role of telomerase activity in pancreatic adenocarcinoma are inconsistent and a systemic review of the available literature may shed new light on this issue. Objective To systematically review the usefulness of telomerase activity in distinguishing pancreatic cancer from other pancreatic diseases. Methods A comprehensive search of the PubMed and Embase databases was conducted to identify eligible studies. Only studies evaluating telomerase activity in patients with suspected or previously diagnosed pancreatic adenocarcinomas versus nonpancreatic adenocarcinomas and published in English with a sufficient number of cases were included. The hierarchical summary receiver operating characteristic (HSROC) model was used to establish the potential value of telomerase activity in the diagnosis of pancreatic adenocarcinoma. Results A total of 19 studies qualified for this meta-analysis. In distinguishing pancreatic adenocarcinoma from benign diseases, the pooled sensitivity and specificity of telomerase activity were 0.81 (95% CI, 0.68-0.90) and 0.97 (95% CI, 0.93-0.98), respectively; the diagnostic odds ratio (DOR) was 126.62 (95% CI, 49.94-320.99); beta was −1.16 (95% CI, −3.62-1.29), Z was −0.93, p was 0.35>0.1, and lambda was 6.86 (95% CI, 1.01-12.70). In distinguishing pancreatic adenocarcinoma from chronic pancreatitis, the pooled sensitivity and specificity of telomerase activity were 0.77 (95% CI, 0.61-0.88) and 0.97 (95% CI, 0.91-0.99), respectively; DOR was 117.28 (95% CI, 32.25-426.53); beta was −0.38 (95% CI, −1.89-1.13), Z was −0.49, p was 0.62>0.1, and lambda was 5.30 (95% CI, 3.37-7.24). Conclusions The present meta-analysis demonstrates that telomerase activity could be a useful biomarker for the differential diagnosis of pancreatic adenocarcinoma and benign pancreatic diseases.

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