TY - JOUR
T1 - Diagnostic performance of imaging modalities in chronic pancreatitis: a systematic review and meta-analysis
T2 - a systematic review and meta-analysis
AU - Issa, Y.
AU - Kempeneers, M. A.
AU - van Santvoort, H. C.
AU - Bollen, T. L.
AU - Bipat, S.
AU - Boermeester, M. A.
N1 - Publisher Copyright: © 2017, The Author(s).
PY - 2017
Y1 - 2017
N2 - Objectives Obtain summary estimates of sensitivity and specificity for imaging modalities for chronic pancreatitis (CP) assessment. Methods A systematic search was performed in Cochrane Library, MEDLINE, Embase and CINAHL databases for studies evaluating imaging modalities for the diagnosis of CP up to September 2016. A bivariate random-effects modeling was used to obtain summary estimates of sensitivity and specificity. Results We included 43 studies evaluating 3460 patients. Sensitivity of endoscopic retrograde cholangiopancreatography (ERCP) (82%; 95% CI: 76%-87%) was significant higher than that of abdominal ultrasonography (US) (67%; 95% CI: 53%-78%; P=0.018). The sensitivity estimates of endoscopic ultrasonography (EUS), magnetic resonance imaging (MRI), and computed tomography (CT) were 81% (95% CI: 70%-89%), 78% (95% CI: 69%-85%), and 75% (95% CI: 66%-83%), respectively, and did not differ significantly from each other. Estimates of specificity were comparable for EUS (90%; 95% CI: 82%-95%), ERCP (94%; 95% CI: 87%-98%), CT (91%; 95% CI: 81%-96%), MRI (96%; 95% CI: 90%-98%), and US (98%; 95% CI: 89%-100%). Conclusions EUS, ERCP, MRI and CT all have comparable high diagnostic accuracy in the initial diagnosis of CP. EUS and ERCP are outperformers and US has the lowest accuracy. The choice of imaging modality can therefore be made based on invasiveness, local availability, experience and costs
AB - Objectives Obtain summary estimates of sensitivity and specificity for imaging modalities for chronic pancreatitis (CP) assessment. Methods A systematic search was performed in Cochrane Library, MEDLINE, Embase and CINAHL databases for studies evaluating imaging modalities for the diagnosis of CP up to September 2016. A bivariate random-effects modeling was used to obtain summary estimates of sensitivity and specificity. Results We included 43 studies evaluating 3460 patients. Sensitivity of endoscopic retrograde cholangiopancreatography (ERCP) (82%; 95% CI: 76%-87%) was significant higher than that of abdominal ultrasonography (US) (67%; 95% CI: 53%-78%; P=0.018). The sensitivity estimates of endoscopic ultrasonography (EUS), magnetic resonance imaging (MRI), and computed tomography (CT) were 81% (95% CI: 70%-89%), 78% (95% CI: 69%-85%), and 75% (95% CI: 66%-83%), respectively, and did not differ significantly from each other. Estimates of specificity were comparable for EUS (90%; 95% CI: 82%-95%), ERCP (94%; 95% CI: 87%-98%), CT (91%; 95% CI: 81%-96%), MRI (96%; 95% CI: 90%-98%), and US (98%; 95% CI: 89%-100%). Conclusions EUS, ERCP, MRI and CT all have comparable high diagnostic accuracy in the initial diagnosis of CP. EUS and ERCP are outperformers and US has the lowest accuracy. The choice of imaging modality can therefore be made based on invasiveness, local availability, experience and costs
KW - Chronic pancreatitis
KW - Diagnostic accuracy
KW - Diagnostic imaging
KW - Meta-analysis
UR - http://www.scopus.com/inward/record.url?scp=85010824722&partnerID=8YFLogxK
U2 - https://doi.org/10.1007/s00330-016-4720-9
DO - https://doi.org/10.1007/s00330-016-4720-9
M3 - Review article
C2 - 28130609
SN - 0938-7994
VL - 27
SP - 3820
EP - 3844
JO - European Radiology
JF - European Radiology
IS - 9
ER -