Meta-analysis of CT and MRI for differentiation of autoimmune pancreatitis from pancreatic adenocarcinoma
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HEPATOBILIARY-PANCREAS
Meta-analysis of CT and MRI for differentiation of autoimmune pancreatitis from pancreatic adenocarcinoma Jiyeon Ha 1 & Sang Hyun Choi 1
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& Jae Ho Byun & Kyung Won Kim & So Yeon Kim & Jin Hee Kim & Hyoung Jung Kim
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Received: 4 April 2020 / Revised: 28 August 2020 / Accepted: 13 October 2020 # European Society of Radiology 2020
Abstract Objectives To systematically determine the diagnostic performance of computed tomography (CT) and magnetic resonance imaging (MRI) for differentiating autoimmune pancreatitis (AIP) from pancreatic ductal adenocarcinoma (PDAC), with a comparison between the two imaging modalities. Methods Literature search was conducted using PubMed and EMBASE databases to identify original articles published between 2009 and 2019 reporting the diagnostic performance of CT and MRI for differentiating AIP from PDAC. The meta-analytic sensitivity and specificity of CT and MRI were calculated, and compared using a bivariate random effects model. Subgroup analysis for differentiating focal AIP from PDAC was performed. Results Of the 856 articles screened, 11 eligible articles are remained, i.e., five studies for CT, four for MRI, and two for both. The meta-analytic summary sensitivity and specificity of CT were 59% (95% confidence interval [CI], 41–75%) and 99% (95% CI, 88–100%), respectively, while those of MRI were 84% (95% CI, 68–93%) and 97% (95% CI, 87–99%). MRI had a significantly higher meta-analytic summary sensitivity than CT (84% vs. 59%, p = 0.02) but a similar specificity (97% vs. 99%, p = 0.18). In the subgroup analysis for focal AIP, the sensitivity for distinguishing between focal AIP and PDAC was lower than that for the overall analysis. MRI had a higher sensitivity than CT (76% vs. 50%, p = 0.28) but a similar specificity (97% vs. 98%, p = 0.07). Conclusion MRI might be clinically more useful to evaluate patients with AIP, particularly for differentiating AIP from PDAC. Key Points • MRI had an overall good diagnostic performance to differentiate AIP from PDAC with a meta-analytic summary estimate of 83% for sensitivity and of 97% for specificity. • CT had a very high specificity (99%), but a suboptimal sensitivity (59%) for differentiating AIP from PDAC. • Compared with CT, MRI had a higher sensitivity, but a similar specificity. Keywords Autoimmune pancreatitis . Pancreatic cancer . Multidetector computed tomography . Magnetic resonance imaging . Meta-analysis
Abbreviations AIP Autoimmune pancreatitis CT Computed tomography Electronic supplementary material The online version of this article (https://doi.org/10.1007/s00330-020-07416-1) contains supplementary material, which is available to authorized users. * Sang Hyun Choi [email protected] 1
Department of Radiology and the Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, 88 Olympic-Ro 43-Gil, Songpa-Gu, Seoul 138-736, South Korea
DWI HSROC MRI MRP PDAC
Diffusion-weighted imaging Hierarchical summary receiver operating characteristic Magnetic
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