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Review
. 2021 Jan 16;11(1):134.
doi: 10.3390/diagnostics11010134.

Endoscopic Ultrasound vs. Computed Tomography for Gastric Cancer Staging: A Network Meta-Analysis

Bogdan Silviu Ungureanu  1 , Victor Mihai Sacerdotianu  1 , Adina Turcu-Stiolica  2 , Irina Mihaela Cazacu  3 , Adrian Saftoiu  1
Affiliations
Review

Endoscopic Ultrasound vs. Computed Tomography for Gastric Cancer Staging: A Network Meta-Analysis

Bogdan Silviu Ungureanu et al. Diagnostics (Basel). .

Abstract

Gastric cancer preoperative staging is of outmost importance to assure proper management of the disease. Providing a relevant clinical stage relies on different imaging methods such as computed tomography (CT) or endoscopic ultrasound (EUS). We aimed to perform a network meta-analysis for gastric cancer clinical stage diagnostic tests, thus comparing the diagnostic accuracy of EUS vs. multidetector CT (MDCT) and EUS vs. EUS + MDCT. We plotted study estimates of pooled sensitivity and specificity on forest plots and summary receiver operating characteristic space to explore between-study variation in the performance of EUS, MDCT and EUS + MDCT for T1-T4, N0-N3, M0-M1 when data were available. Exploratory analyses were undertaken in RevMan 5. We included twelve studies with 2047 patients. Our results suggest that EUS was superior to MDCT in preoperative T1 and N staging. MDCT is more specific for the M stage but no significant difference in sensitivity was obtained. When comparing EUS vs. EUS + MDCT for T1 both sensitivity and specificity were not relevant. No significant differences were observed in T2-T4 stages. Even though EUS helped differentiate between the presence of invaded nodules, N stages should be carefully assessed by both methods since there is not sufficient data.

Keywords: computed tomography; endoscopic ultrasound; gastric cancer staging.

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Conflict of interest statement

The authors declare no conflict of interest. The funders had no role in the design of the study; in the collection, analyses, or interpretation of data; in the writing of the manuscript, or in the decision to publish the results.

Figures

Figure 1
Figure 1
Diagram of the study flow according to the preferred reporting items for systematic reviews and meta-analyses (PRISMA) diagram.
Figure 2
Figure 2
Risk of bias and applicability concerns summary (QUADAS-2).
Figure 3
Figure 3
Forest plot of sensitivity for T1 staging.
Figure 4
Figure 4
Forest plot of specificity for T1 staging.
Figure 5
Figure 5
Pooled sensitivity and specificity for T1 staging of EUS (A) and MDCT (B).
Figure 6
Figure 6
Forest plot of sensitivity for N staging.
Figure 7
Figure 7
Forest plot of specificity for N staging.
Figure 8
Figure 8
Pooled sensitivity and specificity for N staging of EUS (A) and MDCT (B).
Figure 9
Figure 9
Forest plot of sensitivity for N0 staging.
Figure 10
Figure 10
Forest plot of sensitivity for N0 staging.
Figure 11
Figure 11
Pooled sensitivity and specificity for N0 staging of EUS (A) and MDCT (B).
Figure 12
Figure 12
Forest plot of sensitivity for M staging.
Figure 13
Figure 13
Forest plot of specificity for M staging.
Figure 14
Figure 14
Pooled sensitivity and specificity for M staging of EUS (A) and MDCT (B).
Figure 15
Figure 15
Forest plot of sensitivity for T1 staging in EUS vs. EUS + MDCT.
Figure 16
Figure 16
Forest plot of specificity for T1 staging in EUS vs. EUS + MDCT.
Figure 17
Figure 17
Pooled sensitivity and specificity for T1 staging of EUS (A) and EUS + MDCT (B).
See this image and copyright information in PMC

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