Research paperImaging modalities in the diagnosis of pancreatic adenocarcinoma: A systematic review and meta-analysis of sensitivity, specificity and diagnostic accuracy

- Review of papers from Jan 2004 to June 2015.
- A total of 5399 patients, 3567 with PDAC, from 52 studies were included in review.
- All modalities, except PET, equivalent within 95% CI.
- Ultrasound found to be significantly more accurate than in previous reviews.

BackgroundPancreatic cancer, primarily pancreatic ductal adenocarcinoma (PDAC), accounts for 2.4% of cancer diagnoses and 5.8% of cancer death annually. Early diagnoses can improve 5-year survival in PDAC. The aim of this systematic review was to determine the sensitivity, specificity and diagnostic accuracy values for MRI, CT, PET&PET/CT, EUS and transabdominal ultrasound (TAUS) in the diagnosis of PDAC.MethodsA systematic review was undertaken to identify studies reporting sensitivity, specificity and/or diagnostic accuracy for the diagnosis of PDAC with MRI, CT, PET, EUS or TAUS. Proportional meta-analysis was performed for each modality.ResultsA total of 5399 patients, 3567 with PDAC, from 52 studies were included. The sensitivity, specificity and diagnostic accuracy were 93% (95% CI = 88-96), 89% (95% CI = 82-94) and 90% (95% CI = 86-94) for MRI; 90% (95% CI = 87-93), 87% (95% CI = 79-93) and 89% (95% CI = 85-93) for CT; 89% (95% CI = 85-93), 70% (95% CI = 54-84) and 84% (95% CI = 79-89) for PET; 91% (95% CI = 87-94), 86% (95% CI = 81-91) and 89% (95% CI = 87-92) for EUS; and 88% (95% CI = 86-90), 94% (95% CI = 87-98) and 91% (95% C = 87-93) for TAUS.ConclusionThis review concludes all modalities, except for PET, are equivalent within 95% confidence intervals for the diagnosis of PDAC.