Endoscopic ultrasound elastography for differential diagnosis of pancreatic masses: a meta-analysis

Abstract

Background: Distinguishing malignant from benign pancreatic tumors is challenging with current imaging techniques. Endoscopic ultrasound (EUS) elastography has further improved the efficacy of EUS for characterizing pancreatic lesions.

Aims: To assess, by combining data from existing trials, the accuracy of EUS elastography in diagnosing malignant tumors for patients with pancreatic masses.

Methods: All relevant studies published were identified by systematic searching of databases. A meta-analysis was performed using a random-effects model to combine study results.

Results: Seven studies involving 752 patients were included. The sensitivity of EUS elastography for differential diagnosis of solid pancreatic masses was 97 % (95 % CI, 0.95-0.98), and the specificity was 76 % (95 % CI, 0.69-0.82). The area under the curve under summary receiver operating characteristic (SROC) was 0.9529. The combined positive likelihood ratio was 3.71 (95 % CI, 2.72-5.07), and the negative likelihood ratio was 0.05 (95 % CI, 0.02-0.13).

Conclusion: Our meta-analysis shows that EUS elastography is a useful tool for differential diagnosis of solid pancreatic neoplasms with very high sensitivity and relatively low specificity. The results indicate that EUS elastography not only provides information complementary to that from EUS but also potentially increases the yield of fine needle aspiration and reduces the number of unnecessary biopsies.