Diagnostic accuracy of CEUS in identifying Solid Pancreatic Lesions:- A meta analysis

Abstract

AbstractBackgroundSolid pancreatic lesions are crucial to identify because of their high incidence rate and their poor survival rate. Surgical biopsy, ultrasonography, computed tomography, MRI, and PET-CT are examples of diagnostic tools. Although common, endoscopic ultrasonography guided biopsy carries a risk of needle track seeding. A more effective and affordable method for determining the differential diagnosis of solid pancreatic lesions is contrast-enhanced ultrasonography (CEUS). CEUS is a less nephrotoxic method that uses a contrast chemical to distinguish between teratomas, benign tumors, and neuroendocrine tumors. The goal of this meta-analysis is to evaluate how well CEUS can identify solid pancreatic lesions for use in clinical diagnostic procedures.MethodologyMedical literature comprehensively searched and reviewed without restrictions to particular study designs, or publication dates using PubMed, Cochrane Library and Google Scholar databases for all relevant literature. The extraction of necessary data proceeded after specific inclusion and exclusion criteria were applied. Meta Analysis included 27 RCTs and 3061 patients, and analyzed using the QualSyst yool. The risk of bias was evaluated by using QUADAS-2 analysis.The statistical software packages MetaDiSc 1.4, RevMan (Review Manager, version 5.3), SPSS (Statistical Package for the Social Sciences, version 20) and Excel in Stata 14 were used to perform the statistical analyses.ResultAccording to the findings of four studies, CEUS demonstrates high sensitivity, with values equal to or above 95%, and one study indicates specificity above 95%. True Positive (TP) and True Negative (TN) values are reported as 2080 and 621, respectively, while False Positive (FP) and False Negative (FN) values are noted as 124 and 236. With a 95% confidence interval, CEUS sensitivity is calculated as 0.90 (range: 0.89 to 0.91) and specificity as 0.83 (range: 0.80 to 0.86). The positive predictive value (PPV) of CEUS is estimated at approximately 94.3%. These results highlight CEUS as a promising tool for diagnosing pancreatic lesions.ConclusionThe study concluded that CEUS (Contrast-Enhanced Ultrasound) is an important diagnostic test for pancreatic lesions. This is due to their high sensitivity and specificity, along with other aspects like enhanced visualization, real-time imaging, and safety benefits. Additionally, CEUS is cost-effective, making it a practical choice in healthcare settings with budget constraints.Thus, CEUS remains a valuable asset for healthcare professionals in their efforts to accurately diagnose pancreatic lesions.