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

Abstract 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).