Diagnostic performance of contrast-enhanced ultrasound for pancreatic neoplasms: A systematic review and meta-analysis.

BACKGROUND: Early diagnosis of pancreatic cancer is essential to optimize treatment strategies.

OBJECTIVES: To evaluate the diagnostic performance of contrast-enhanced ultrasound for benign and malignant pancreatic neoplasms.

DATA SOURCES: Pubmed, Embase, Web of Science, and Cochrane Library databases.

STUDY ELIGIBILITY CRITERIA: Retrospective or prospective studies.

PARTICIPANTS: Patients with a confirmed diagnosis of benign and malignant pancreatic neoplasms.

INTERVENTION: Contrast-enhanced ultrasound.

STUDY APPRAISAL AND SYNTHESIS: Pooled sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, diagnostic risk ratio, and corresponding 95% confidence intervals; summary receiver operating characteristic (SROC) curve; a Fagan nomogram.

RESULTS: Ten studies involving 641 patients were included. Pooled sensitivity, specificity, and positive and negative predictive values were 91% (95% CI: 87%, 93%), 87% (95% CI: 78%, 93%), 7.2 (95% CI: 4.3, 12.3), and 0.11 (95% CI: 0.08, 0.15), respectively; and the odds ratio for diagnosis was 67 (95% CI: 34, 113). Contrast-enhanced ultrasound had good diagnostic ability and accuracy. Pre- and post-test probability of disease was 50% and 88%, respectively, when the positive likelihood ratio was 7.

CONCLUSION: Contrast-enhanced ultrasound can be used for qualitative diagnosis of benign and malignant pancreatic neoplasms.

IMPLICATIONS OF KEY FINDINGS: CEUS should be considered as an important imaging tool for the characterization of pancreatic tumors.

SYSTEMATIC REVIEW REGISTRATION NUMBER: CRD42017070434 (PROSPERO).