Highlights
- •A new table summarized clinical features that characterized the IPMN as malignant.
- •Meta-analysis compares the diagnostic performance of all possible imaging modalities for differentiation of malignant IPMNs.
- •Both PET/CT and DWI performed better diagnostic accuracy in the detection of malignant IPMN.
- •It is the first meta-analysis to investigate the different imaging modalities in benign and malignant diagnosis of IPMN.
Abstract
Purpose
The objective of this study was to assess the diagnostic properties of computed tomography
(CT), magnetic resonance imaging (MRI/MRCP) /Magnetic Resonance Cholangiopancreatography
(MRCP), positron emission tomography/computed tomography (PET/CT), endoscopic ultrasound
(EUS) and diffusion-weighted magnetic resonance imaging (DWI) in distinguishing benign
and malignant intraductal papillary mucinous neoplasm (IPMN).
Materials and methods
Eligible databases were searched for eligible studies, published through July 2020
on the diagnostic accuracy of these modalities. Diagnostic accuracy parameters, including
sensitivity, specificity, diagnostic odds ratio (DOR), and summary receiver operating
characteristic curves (SROC) were calculated. Meta-regression was performed to identify
the source of heterogeneity.
Results
In total, 28 studies were included. Pooled sensitivities for CT, MRI/MRCP, PET/CT,
EUS and DWI were 0.7, 0.76, 0.8, 0.6 and 0.72, respectively. Pooled specificities
were 0.78, 0.83, 0.9, 0.8 and 0.97. The DORs were 8, 16, 35, 6 and 88. The areas under
the curve (AUC) of SROC for CT, MRI/MRCP/MRCP, PET/CT, EUS and DW were 0.8, 0.87,
0.92, 0.79 and 0.82, respectively.
Conclusion
PET/CT showed the highest AUC and the overall diagnostic accuracy results support
the use of MRI/MRCP, PET/CT interchangeably as a first-line examination in the diagnosis
of malignant IPMN. With regard to DWI, EUS and CT, each techniques have their advantages
and supportive to MRI/MRCP.
Abbreviations:
AUC (area under the curve), BD (branch-duct), CI (confidence intervals), CT (computed tomography), DOR (diagnostic odds ratios), CNKI (China National Knowledge Infrastructure), DWI (diffusion-weighted magnetic resonance imaging), EUS (endoscopic ultrasound), FPs (false-positives), FNs (false-negatives), IPMN (intraductal papillary mucinous neoplasm), MD (main-duct), MPD (main pancreatic duct), MRCP (magnetic resonance cholangiopancreatography), MRI/MRCP (magnetic resonance imaging), PET/CT (positron emission tomography with computed tomography), QUADAS-2 (quality assessment for diagnostic accuracy study form), SROCs (summary receiver operating characteristic curves), TPs (true-positives), TNs (true-negatives)Keywords
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Article info
Publication history
Published online: December 02, 2020
Accepted:
November 8,
2020
Received in revised form:
October 9,
2020
Received:
July 23,
2020
Identification
Copyright
© 2020 Elsevier Inc. All rights reserved.
