1. Value of Low-Mechanical-Index Contrast-Enhanced Transabdominal Ultrasound for Diagnosis of Pancreatic Cancer: A Meta-analysis
- Author
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Masayuki Kitano, Atsushi Sofuni, Mirko D'Onofrio, Reiko Ashida, Toshio Shimokawa, Masatoshi Kudo, Christoph F. Dietrich, Hideaki Mori, Yoshiki Hirooka, and Yasunobu Yamashita
- Subjects
medicine.medical_specialty ,Acoustics and Ultrasonics ,Contrast-enhanced transabdominal ultrasound ,Biophysics ,Contrast Media ,Sensitivity and Specificity ,Likelihood ratios in diagnostic testing ,Diagnosis, Differential ,Pancreatic cancer ,medicine ,Humans ,Radiology, Nuclear Medicine and imaging ,Enhancement pattern ,Low mechanical index ,Meta-analysis ,Pancreas ,Ultrasonography ,Radiological and Ultrasound Technology ,Receiver operating characteristic ,business.industry ,Ultrasound ,medicine.disease ,Confidence interval ,Pancreatic Neoplasms ,Diagnostic odds ratio ,Radiology ,Differential diagnosis ,business ,Mechanical index - Abstract
The incidence and mortality rates of pancreatic cancer (PC) are increasing. It is important to discriminate PC from the other pancreatic lesions; however, differential diagnosis based on conventional transabdominal ultrasound (US) remains challenging even though US is often the first examination performed. Transabdominal contrast-enhanced ultrasound (CEUS) has high diagnostic accuracy for PC. This meta-analysis aimed to examine the utility of low-mechanical-index CEUS with enhancement for PC diagnosis. A systematic meta-analysis of all potentially relevant articles was performed. Fixed-effects or random-effects models were used to investigate pooled sensitivity, specificity, positive likelihood ratio (LR) and negative LR. The study enrolled 983 patients from nine eligible studies. The pooled estimates of sensitivity and specificity were 92% (95% confidence interval [CI]: 0.89-0.94) and 76% (95% CI: 0.71-0.81), respectively. The diagnostic odds ratio (DOR) for CEUS was high (53.62). The area under the summary receiver operating characteristic curve was 0.95. Funnel plots revealed no publication bias, and there was no significant relationship between the DORs and study characteristics, including continent, type of contrast agent, contrast agent dosage and scan phase. Only number of patients affected diagnostic ability. This meta-analysis indicates that CEUS with enhancement pattern is useful for diagnosis of PC.
- Published
- 2021