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

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Title: Diagnostic performance of imaging modalities in chronic pancreatitis: a systematic review and meta-analysis.
Authors: Issa, Y.1, Kempeneers, M.1, Santvoort, H.1, Bollen, T.2, Bipat, S.3, Boermeester, M.1 m.a.boermeester@amc.uva.nl, Kempeneers, M A4 (AUTHOR), van Santvoort, H C4 (AUTHOR), Bollen, T L5 (AUTHOR), Boermeester, M A4 (AUTHOR)
Source: European Radiology. Sep2017, Vol. 27 Issue 9, p3820-3844. 25p.
Subjects: Chronic pancreatitis, Endoscopic retrograde cholangiopancreatography, Ultrasonic imaging of the abdomen, Endoscopic ultrasonography, Magnetic resonance imaging, Computed tomography, Diagnostic imaging, Meta-analysis, Pancreatitis, Systematic reviews, Acute diseases
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. [ABSTRACT FROM AUTHOR]
Copyright of European Radiology is the property of Springer Nature and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
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  Data: Diagnostic performance of imaging modalities in chronic pancreatitis: a systematic review and meta-analysis.
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  Data: <searchLink fieldCode="AR" term="%22Issa%2C+Y%2E%22">Issa, Y.</searchLink><relatesTo>1</relatesTo><br /><searchLink fieldCode="AR" term="%22Kempeneers%2C+M%2E%22">Kempeneers, M.</searchLink><relatesTo>1</relatesTo><br /><searchLink fieldCode="AR" term="%22Santvoort%2C+H%2E%22">Santvoort, H.</searchLink><relatesTo>1</relatesTo><br /><searchLink fieldCode="AR" term="%22Bollen%2C+T%2E%22">Bollen, T.</searchLink><relatesTo>2</relatesTo><br /><searchLink fieldCode="AR" term="%22Bipat%2C+S%2E%22">Bipat, S.</searchLink><relatesTo>3</relatesTo><br /><searchLink fieldCode="AR" term="%22Boermeester%2C+M%2E%22">Boermeester, M.</searchLink><relatesTo>1</relatesTo><i> m.a.boermeester@amc.uva.nl</i><br /><searchLink fieldCode="AR" term="%22Kempeneers%2C+M+A%22">Kempeneers, M A</searchLink><relatesTo>4</relatesTo> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22van+Santvoort%2C+H+C%22">van Santvoort, H C</searchLink><relatesTo>4</relatesTo> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Bollen%2C+T+L%22">Bollen, T L</searchLink><relatesTo>5</relatesTo> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Boermeester%2C+M+A%22">Boermeester, M A</searchLink><relatesTo>4</relatesTo> (AUTHOR)
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  Data: <searchLink fieldCode="JN" term="%22European+Radiology%22">European Radiology</searchLink>. Sep2017, Vol. 27 Issue 9, p3820-3844. 25p.
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  Data: <searchLink fieldCode="DE" term="%22Chronic+pancreatitis%22">Chronic pancreatitis</searchLink><br /><searchLink fieldCode="DE" term="%22Endoscopic+retrograde+cholangiopancreatography%22">Endoscopic retrograde cholangiopancreatography</searchLink><br /><searchLink fieldCode="DE" term="%22Ultrasonic+imaging+of+the+abdomen%22">Ultrasonic imaging of the abdomen</searchLink><br /><searchLink fieldCode="DE" term="%22Endoscopic+ultrasonography%22">Endoscopic ultrasonography</searchLink><br /><searchLink fieldCode="DE" term="%22Magnetic+resonance+imaging%22">Magnetic resonance imaging</searchLink><br /><searchLink fieldCode="DE" term="%22Computed+tomography%22">Computed tomography</searchLink><br /><searchLink fieldCode="DE" term="%22Diagnostic+imaging%22">Diagnostic imaging</searchLink><br /><searchLink fieldCode="DE" term="%22Meta-analysis%22">Meta-analysis</searchLink><br /><searchLink fieldCode="DE" term="%22Pancreatitis%22">Pancreatitis</searchLink><br /><searchLink fieldCode="DE" term="%22Systematic+reviews%22">Systematic reviews</searchLink><br /><searchLink fieldCode="DE" term="%22Acute+diseases%22">Acute diseases</searchLink>
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  Data: <bold>Objectives: </bold>Obtain summary estimates of sensitivity and specificity for imaging modalities for chronic pancreatitis (CP) assessment.<bold>Methods: </bold>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.<bold>Results: </bold>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%).<bold>Conclusions: </bold>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.<bold>Key Points: </bold>• 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. [ABSTRACT FROM AUTHOR]
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  Data: <i>Copyright of European Radiology is the property of Springer Nature and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.)
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        Value: 10.1007/s00330-016-4720-9
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