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Meta-Analysis
. 2017 Sep;27(9):3820-3844.
doi: 10.1007/s00330-016-4720-9. Epub 2017 Jan 27.

Diagnostic performance of imaging modalities in chronic pancreatitis: a systematic review and meta-analysis

Y Issa  1 , M A Kempeneers  1 , H C van Santvoort  1 , T L Bollen  2 , S Bipat  3 , M A Boermeester  4
Affiliations
Meta-Analysis

Diagnostic performance of imaging modalities in chronic pancreatitis: a systematic review and meta-analysis

Y Issa et al. Eur Radiol. 2017 Sep.

Abstract

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.

Key points: • EUS, ERCP, MRI and CT have high diagnostic sensitivity for chronic pancreatitis • Diagnostic specificity is comparable for all imaging modalities • EUS and ERCP are outperformers and US has the lowest accuracy • The choice of imaging can be made based on clinical considerations.

Keywords: Chronic pancreatitis; Diagnostic accuracy; Diagnostic imaging; Meta-analysis.

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Figures

Fig. 1
Fig. 1
Flow chart
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Fig. 2
Summary of study quality (QUADAS-2)
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Fig. 3
Forest plot for sensitivity and specificity
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Fig. 4
Receiver operator curves (ROC)
See this image and copyright information in PMC

References

    1. Gardner TB, Kennedy AT, Gelrud A, et al. Chronic pancreatitis and its effect on employment and health care experience: results of a prospective American multicenter study. Pancreas. 2010;39:498–501. doi: 10.1097/MPA.0b013e3181c5c693. - DOI - PubMed
    1. Hall TC, Garcea G, Webb MA, Al-Leswas D, Metcalfe MS, Dennison AR. The socio-economic impact of chronic pancreatitis: a systematic review. J Eval Clin Pract. 2014;20:203–207. doi: 10.1111/jep.12117. - DOI - PubMed
    1. Mullady DK, Yadav D, Amann ST, et al. Type of pain, pain-associated complications, quality of life, disability and resource utilisation in chronic pancreatitis: a prospective cohort study. Gut. 2011;60:77–84. doi: 10.1136/gut.2010.213835. - DOI - PMC - PubMed
    1. Olesen SS, Juel J, Nielsen AK, Frokjaer JB, Wilder-Smith OH, Drewes AM. Pain severity reduces life quality in chronic pancreatitis: implications for design of future outcome trials. Pancreatology. 2014;14:497–502. doi: 10.1016/j.pan.2014.09.009. - DOI - PubMed
    1. Buchler MW, Martignoni ME, Friess H, Malfertheiner P. A proposal for a new clinical classification of chronic pancreatitis. BMC Gastroenterol. 2009;9:93. doi: 10.1186/1471-230X-9-93. - DOI - PMC - PubMed

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