scholarly journals Diagnostic Performance of Noninvasive Imaging Modalities for Localization of Insulinoma: A Meta-Analysis

Author(s):  
Yi Yang ◽  
Jian Shi ◽  
Jianbing Zhu

Abstract BackgroundInsulinomas is the most common functional neuroendocrine tumor found only in the pancreas. The early detection of insulinoma is of importance. Studies comparing the performance of noninvasive modalities were limited by sample size and heterogeneity between studies. The aim of this meta-analysis was to evaluate the diagnostic performance of PET/CT, SPECT/CT, CT and MRI for the localization of insulinoma, and to provide evidence for clinical practice.MethodsPubMed, Embase, Cochrane Library, Wanfang Data and China National Knowledge Infrastructure were searched from inception to May 31, 2021. Pooled sensitivity, specificity, positive Likelihood Ratio (+LR) and negative Likelihood Ratio (-LR), diagnostic odds ratio (DOR), and concordance rate were calculated.ResultsA total of 19 studies including 708 patients of insulinoma reached the inclusion criteria. PET/CT imaging demonstrated a pooled sensitivity of 0.79 (95% CI: 0.54–0.92) and a pooled specificity of 0.84 (95% CI: 0.20–0.99). The pooled sensitivity and specificity of SPECT/CT were 0.77 (95% CI: 0.46–0.93) and 0.45 (95% CI: 0.22–0.70). CT showed an overall sensitivity of 0.54 (95% CI:0.35–0.72) and specificity of 0.75 (95% CI: 0.54–0.88). The pooled sensitivity and specificity for MRI were 0.54 (95% CI: 0.31–0.75) and 0.65 (95% CI: 0.39–0.84), respectively. The concordance rates of PET, SPECT, CT, and MRI were 78% (95% CI: 66%-90%), 74% (95% CI: 52%-97%), 56% (95% CI: 41%-72%), and 53% (95% CI: 33%-73%), respectively.ConclusionResults of this study indicate that PET/CT demonstrated superior performance than SPECT/CT, CT and MRI for the localization of insulinoma. GLP-1R based PET/CT manifested better diagnostic performance in comparison with SSTR based PET/CT imaging modality.

BMC Cancer ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Xianwen Hu ◽  
Dandan Li ◽  
Zhigang Liang ◽  
Yan Liao ◽  
Ling Yang ◽  
...  

Abstract Objective To compare the value of fluorodeoxyglucose positron emission tomography (FDG-PET)/computed tomography (CT) and magnetic resonance imaging (MRI) in differentiating benign and malignant ovarian or adnexal tumors. Materials and methods English articles reporting on the diagnostic performance of MRI or 18F-FDG PET/CT in identifying benign and malignant ovarian or adnexal tumors published in PubMed and Embase between January 2000 and January 2021 were included in the meta-analysis. Two authors independently extracted the data. If the data presented in the study report could be used to construct a 2 × 2 contingency table comparing 18F-FDG PET/CT and MRI, the studies were selected for the analysis. The Quality Assessment of Diagnostic Accuracy Studies-2 (QUADAS-2) was used to evaluate the quality of the included studies. Forest plots were generated according to the sensitivity and specificity of 18F-FDG PET/CT and MRI. Results A total of 27 articles, including 1118F-FDG PET/CT studies and 17 MRI studies on the differentiation of benign and malignant ovarian or adnexal tumors, were included in this meta-analysis. The pooled sensitivity and specificity for 18F-FDG PET/CT in differentiating benign and malignant ovarian or adnexal tumors were 0.94 (95% CI, 0.87–0.97) and 0.86 (95% CI, 0.79–0.91), respectively, and the pooled sensitivity and specificity for MRI were 0.92 (95% CI: 0.89–0.95) and 0.85 (95% CI: 0.79–0.89), respectively. Conclusion While MRI and 18F-FDG PET/CT both showed to have high and similar diagnostic performance in the differential diagnosis of benign and malignant ovarian or adnexal tumors, MRI, a promising non-radiation imaging technology, may be a more suitable choice for patients with ovarian or accessory tumors. Nonetheless, prospective studies directly comparing MRI and 18F-FDG PET/CT diagnostic performance in the differentiation of benign and malignant ovarian or adnexal tumors are needed.


2021 ◽  
Author(s):  
Xianwen Hu ◽  
Dandan Li ◽  
Zhigang Liang ◽  
Yan Liao ◽  
Ling Yang ◽  
...  

Abstract Objective: To compare the value of Fluorodeoxyglucose positron emission tomography (FDG-PET)/computed tomography (CT) and magnetic resonance imaging(MRI) in differentiating benign and malignant ovarian tumors.Material and Methods: Retrieved the research on the diagnostic performance of MRI or 18F-FDG PET/CT in identifying benign and malignant ovarian tumors published in PubMed and Embase from January 2000 to January 2021. Two authors independently extracted the data of the characteristics of each study. If the data of the study report can be used to construct a 2X2 contingency table comparing 18F-FDG PET/CT and MRI, these studies were selected. The Quality Assessment of Diagnostic Accuracy Studies were used to evaluate the quality of the studies. According to the sensitivity and specificity of 18F-FDG PET/CT and MRI, forest plots is generated.Results:A total of 27 articles including 1118F-FDG PET/CT studies and 17 MRI studies on the differentiation of benign and malignant ovarian or accessory tumors were included for this meta-analysis. The pooled sensitivity and specificity for 18F-FDG PET/CT in differentiating benign and malignant ovarian tumors were 0.92 (95% CI, 0.86-0.96) and 0.86 (95% CI, 0.79-0.91), respectively, and the pooled sensitivity and specificity for MRI were 0.92 (95% CI: 0.89-0.95) and 0.85 (95% CI: 0.79-0.89), respectively.Conclusion:MRI and 18F-FDG PET/CT have the same diagnostic performance in the differential diagnosis of ovarian benign and malignant tumors. However, MRI is more worthy of clinical application because of its lack of radiation, shorter scanning time, and lower medical costs.


2018 ◽  
Vol 25 (6) ◽  
pp. 643-652 ◽  
Author(s):  
Seong-Jang Kim ◽  
Sang-Woo Lee ◽  
Kyoungjune Pak ◽  
Sung-Ryul Shim

We aimed to explore the role of the diagnostic accuracy of F-18 fluorodeoxyglucose positron emission tomography/computed tomography (PET/CT) for the detection of recurrent and/or metastatic diseases in differentiated thyroid cancer (DTC) patients with progressively and/or persistently elevated TgAb levels and negative radioactive iodine whole-body scan (RI-WBS) through a systematic review and meta-analysis. The MEDLINE, EMBASE and Cochrane Library database, from the earliest available date of indexing through June 30, 2017, were searched for studies evaluating the diagnostic performance of F-18 FDG PET/CT for the detection of recurrent and/or metastatic diseases in DTC patients with progressively and/or persistently elevated TgAb levels and negative RI-WBS. We determined the sensitivities and specificities across studies, calculated positive and negative likelihood ratios (LR+ and LR−). Across 9 studies (515 patients), the pooled sensitivity for F-18 FDG PET/CT was 0.84 (95% CI; 0.77–0.89) a pooled specificity of 0.78 (95% CI; 0.67–0.86). Likelihood ratio (LR) syntheses gave an overall positive likelihood ratio (LR+) of 3.8 (95% CI; 2.5–5.7) and negative likelihood ratio (LR−) of 0.21 (95% CI; 0.14–0.30). The pooled diagnostic odds ratio (DOR) was 18 (95% CI; 10–34). The area (AUC) under the hierarchical summary receiver-operating characteristic (HCROC) curve was 0.88 (95% CI: 0.85–0.90). F-18 FDG PET or PET/CT demonstrated moderate sensitivity and specificity for the detection of recurrent and/or metastatic diseases in DTC patients with progressively and/or persistently elevated TgAb levels and negative RI-WBS.


2021 ◽  
Author(s):  
Yuan Chen ◽  
Faiza Naz ◽  
Shi Fu ◽  
Mengran Shi ◽  
Haihao Li ◽  
...  

Abstract Background: In recent years, qualitative and quantitative analysis of LncRNA has been reported as a potential method for early diagnosis of bladder cancer, but the results from each research are insufficient and not completely consistent. This meta-analysis aims to evaluate the diagnostic value of LncRNA for BC.Methods: We conducted a diagnostic meta-analysis and the diagnostic significance of LncRNA in blood, urine and tumor tissues was discussed. We searched the PUBMED, EMABASE, and Cochrane Library until June 2020. The current meta-analysis was performed using Review Manager 5.2, Stata 16.0 and Meta-Disc 1.4 software. Results: A total of 18 researches involving early and/or advanced bladder cancer were finally included. The overall diagnostic accuracy was measured as follows: pooled sensitivity and specificity were 0.72 (95%CI:0.70, 0.73) and 0.76 (95%CI: 0.75, 0.78). Pooled positive likelihood ratio and negative likelihood ratio were 3.09 (95%CI: 2.66, 3.58) and 0.37 (95%CI: 0.33, 0.42). Combined diagnostic odds ratio was 9.43 (95%CI: 7.30, 12.20). A high diagnostic accuracy was demonstrated by the summary receiver operating characteristic curve, with area under the curve of 0.82 (95%CI: 0.78, 0.85). UCA1 and H19 had the best diagnostic effect, their diagnostic sensitivity and specificity were 80%, 79% and 79%, 73% respectively, the combined diagnostic odds ratio was 16.85 and 12.67 respectively.Conclusions: This meta-analysis suggests that LncRNA have great potential in the diagnosis of bladder cancer, UCA1 and H19 had the best diagnostic effect. LncRNA panel is the future development direction in the diagnosis of bladder cancer. However, larger sample researches are needed to further confirm our conclusion.


2020 ◽  
Vol 2020 ◽  
pp. 1-16 ◽  
Author(s):  
Meng-Yi Han ◽  
Tian-Ao Xie ◽  
Jia-Xin Li ◽  
Hui-Jin Chen ◽  
Xiao-Hui Yang ◽  
...  

Background. Influenza virus mainly causes acute respiratory infections in humans. However, the diagnosis of influenza is not accurate based on clinical evidence, as the symptoms of flu are similar to other respiratory virus. The lateral-flow assay is a rapid method to detect influenza virus. But the effectiveness of the technique in detecting flu viruses is unclear. Hence, a meta-analysis would be performed to evaluate the accuracy of LFA in detecting influenza virus. Methods. Relevant literature was searched out in PubMed, Embase, Web of Science, and Cochrane Library databases with the keywords “lateral flow assay” and “flu virus”. By Meta-DiSc software, pooled sensitivity, pooled specificity, positive likelihood ratio (PLR), negative likelihood ratio (NLR), diagnostic odds ratio (DOR), summary receiver operating characteristic curve (SROC), and area under the curve (AUC) can be calculated. Results. This meta-analysis contains 13 studies and 24 data. The pooled sensitivity and specificity of the influenza virus detected by LFA were 0.84 (95% CI: 0.82-0.86) and 0.97 (95% CI: 0.97-0.98), respectively. The pooled values of PLR, NLR, DOR, and SROC were 32.68 (17.16-62.24), 0.17 (0.13-0.24), 334.07 (144.27-773.53), and 0.9877. No publication bias was found. Conclusions. LFA exhibited high sensitivity and specificity in diagnosing influenza virus. It is a valuable alternative method which can diagnose influenza virus quickly. However, more evidence is required to confirm whether LFA is comparable to traditional methods for detecting the virus.


2021 ◽  
Vol 2021 ◽  
pp. 1-14
Author(s):  
Lili Wang ◽  
Yuhan Liu ◽  
Chen Lyu ◽  
Alexander Buchner ◽  
Heike Pohla

Introduction. It has been shown that miR-192 is abnormally expressed in a variety of cancer types and participates in different kinds of signaling pathways. The role of miR-192 in the diagnosis and prognosis of cancer has not been verified. This article is aimed at exploring the diagnostic and prognostic value of miR-192 through a systematic review and meta-analysis. Methods. A systematic search was performed through PubMed, Embase, Web of Science, and Cochrane Library databases up to June 16, 2020. A total of 16 studies were enrolled in the meta-analyses, of which 11 articles were used for diagnostic meta-analysis and 5 articles were used for prognostic meta-analysis. The values of sensitivity and specificity using miR-192 expression as a diagnostic tool were pooled in the diagnostic meta-analysis. The hazard ratios (HRs) of overall survival (OS) with 95 confidence intervals (CIs) were extracted from the studies, and pooled HRs were evaluated in the prognostic meta-analysis. Eleven studies including 667 cancer patients and 514 controls met the eligibility criteria for the diagnostic meta-analysis. Five studies including 166 patients with high miR-192 expression and 236 patients with low miR-192 expression met the eligibility criteria for the prognostic meta-analysis. Results. The overall diagnostic accuracy was as follows: sensitivity 0.79 ( 95 % CI = 0.75 -0.82), specificity 0.74 ( 95 % CI = 0.64 -0.82), positive likelihood ratio 3.03 ( 95 % CI = 2.11 -4.34), negative likelihood ratio 0.29 ( 95 % CI = 0.23 -0.37), diagnostic odds ratio 10.50 ( 95 % CI = 5.89 -18.73), and area under the curve ratio (AUC) 0.82 ( 95 % CI = 0.78 -0.85). The overall prognostic analysis showed that high expression of miR-192 in patients was associated with positive survival ( HR = 0.62 , 95 % CI : 0.41 -0.93, p = 0.020 ). Conclusion. Our results revealed that miR-192 was a potential biomarker with good sensitivity and specificity in cancers. Moreover, highly expressed miR-192 predicted a good prognosis for patients.


2021 ◽  
pp. 875647932199234
Author(s):  
Sharareh Sanei Sistani ◽  
Fateme Parooie

Objectives: A chest radiograph (CXR) is still the preferred diagnostic method when pneumonia is suspected, although the sensitivity is relatively low. The aim of this study was to compare the diagnostic sensitivity, specificity, and accuracy of ultrasonography (US) for the diagnosis of community-acquired pneumonia (CAP), compared with CXR. Materials and Methods: A principled search was conducted to identify original English articles using PubMed, EMBASE, Web of Science, Scopus, and the Cochrane library, with the end date of October 2020. A combination of keywords, such as “ultrasound” or “ultrasonography,” “pneumonia,” “sensitivity,” and “specificity,” was used. Methodologic quality was assessed using Quality Assessment of Diagnostic Accuracy Studies 2 criteria. Statistical analysis was completed on the resulting study data. Results: The search produced 16 eligible articles that reported on 2040 patients. The overall pooled sensitivity for US and CXR, to diagnose pneumonia, was 0.96 and 0.65, respectively. The overall pooled specificity for US and CXR was 0.85 and 0.81, respectively. The overall pooled positive likelihood ratio for US and CXR was 9.74 and 3.67, respectively. The negative likelihood ratio for US and CXR was 0.05 and 0.42, respectively. In addition, summary receiver operative characteristics areas under the curve were 0.98 for US and 0.77 for CXR. Conclusion: This review demonstrated that lung US is a useful technique for the diagnosis of pneumonia. This diagnostic method can be used by emergency physicians with high accuracy, sensitivity, and specificity. Among an elderly population, this diagnostic method may be a better choice than CXR. The rapid performance of lung US may facilitate a quick, cost-effective, and safe diagnosis of this potentially fatal disease.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Bo Zhang ◽  
Bingjie Zhang ◽  
Zhulin Zhou ◽  
Yutong Guo ◽  
Dan Wang

AbstractObjectiveGlycosylated hemoglobin (HbA1c) has obvious clinical value in the diagnosis of diabetes, but the conclusions on the diagnostic value of diabetic retinopathy (DR) are not consistent. This study aims to comprehensively evaluate the accuracy of glycosylated hemoglobin in the diagnosis of diabetic retinopathy through the meta-analysis of diagnostic tests.MethodsCochrane Library, Embase, PubMed, Web of Science, China National Knowledge Infrastructure (CNKI), China Wanfang Database, Chinese Biomedical Literature Database (CBM) were searched until November, 2020. The Quality Assessment of Diagnostic Accuracy Studies-2 (QUADAS-2) tool was used to assess the quality of the included studies. The pooled sensitivity, specificity, positive likelihood ratio (+LR), negative likelihood ratio (-LR), diagnostic odds ratio (DOR) and areas under the receiver operating characteristic (ROC) curve were calculated by Stata 15.0 software.ResultsAfter screening, 18 high-quality papers were included. The results of meta-analysis showed that the combined DOR = 18.19 (95% CI: 10.99–30.11), the sensitivity= 0.81 (95% CI): 0.75 ~ 0.87), specificity = 0.81 (95%CI: 0.72 ~ 0.87), +LR = 4.2 (95%CI: 2.95 ~ 6.00), −LR = 0.23 (95%CI: 0.17 ~ 0.31), and the area under the Summary ROC curve was 0.88 (95%CI:  0.85 ~ 0.90).ConclusionThe overall accuracy of HbA1cC forin diagnosing diabetic retinopathy is good. As it is more stable than blood sugar and is not affected by meals, it may be a suitable indicator for diabetic retinopathy.


2021 ◽  
pp. 1-11
Author(s):  
Bing-Jie Xiang ◽  
Min Jiang ◽  
Ming-Jun Sun ◽  
Cong Dai

<b><i>Objective:</i></b> Fecal calprotectin (FC) is a promising marker for assessment of inflammatory bowel disease (IBD) activity. However, the utility of FC for predicting mucosal healing (MH) of IBD patients has yet to be clearly demonstrated. The objective of our study was to perform a meta-analysis evaluating the diagnostic accuracy of FC in predicting MH of IBD patients. <b><i>Methods:</i></b> We systematically searched the databases for studies from inception to April 2020 that evaluated MH in IBD. The methodological quality of each study was assessed according to the Quality Assessment of Diagnostic Accuracy Studies checklist. The extracted data were pooled using a summary receiver operating characteristic curve model. Random-effects model was used to summarize the diagnostic odds ratio, sensitivity, specificity, positive likelihood ratio, and negative likelihood ratio. <b><i>Results:</i></b> Sixteen studies comprising 1,682 ulcerative colitis (UC) patients and 4 studies comprising 221 Crohn’s disease (CD) patients were included. The best performance of FC for predicting MH in UC was at cut-off range of 60–75 μg/g with area under the curve (AUC) of 0.88 and pooled sensitivity and specificity of 0.87 and 0.79, respectively. The pooled sensitivity and specificity values of cutoff range 180–250 μg/g for predicting MH in CD were 0.67 and 0.76, respectively. The AUC of 0.79 also revealed improved discrimination for identifying MH in CD with FC concentration. <b><i>Conclusion:</i></b> Our meta-analysis has found that FC is a simple, reliable noninvasive marker for predicting MH in IBD patients. FC cutoff range 60–75 μg/g appears to have the best overall accuracy in UC patients.


2021 ◽  
Vol 11 (6) ◽  
pp. 568
Author(s):  
Óscar Rapado-González ◽  
Cristina Martínez-Reglero ◽  
Ángel Salgado-Barreira ◽  
Laura Muinelo-Romay ◽  
Juan Muinelo-Lorenzo ◽  
...  

DNA hypermethylation is an important epigenetic mechanism for gene expression inactivation in head and neck cancer (HNC). Saliva has emerged as a novel liquid biopsy representing a potential source of biomarkers. We performed a comprehensive meta-analysis to evaluate the overall diagnostic accuracy of salivary DNA methylation for detecting HNC. PubMed EMBASE, Web of Science, LILACS, and the Cochrane Library were searched. Study quality was assessed by the Quality Assessment for Studies of Diagnostic Accuracy-2, and sensitivity, specificity, positive likelihood ratio (PLR), negative likelihood ratio (NLR), diagnostic odds ratio (dOR), and their corresponding 95% confidence intervals (CIs) were calculated using a bivariate random-effect meta-analysis model. Meta-regression and subgroup analyses were performed to assess heterogeneity. Eighty-four study units from 18 articles with 8368 subjects were included. The pooled sensitivity and specificity of salivary DNA methylation were 0.39 and 0.87, respectively, while PLR and NLR were 3.68 and 0.63, respectively. The overall area under the curve (AUC) was 0.81 and the dOR was 8.34. The combination of methylated genes showed higher diagnostic accuracy (AUC, 0.92 and dOR, 36.97) than individual gene analysis (AUC, 0.77 and dOR, 6.02). These findings provide evidence regarding the potential clinical application of salivary DNA methylation for HNC diagnosis.


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