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.