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Meta-analysis of CT and MRI for differentiation of autoimmune pancreatitis from pancreatic adenocarcinoma

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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.
Author(s)
하지연최상현변재호김경원김소연김진희김형중
Issued Date
2021
Type
Article
Keyword
AdenocarcinomaAdenocarcinoma - diagnostic imagingAutoimmune Diseases - diagnostic imagingAutoimmune PancreatitisCT imagingDiagnosisDifferential|Diagnostic RadiologyHepatobiliary-PancreasHumansImagingInternal MedicineInterventional RadiologyMagnetic Resonance ImagingMedicineMedicine & Public HealthNeuroradiologyPancreatic cancerPancreatic Neoplasms - diagnostic imagingPancreatitisPancreatitis - diagnostic imagingRadiologySensitivity and SpecificityTomographyX-Ray ComputedUltrasound
DOI
10.1007/s00330-020-07416-1
URI
https://oak.ulsan.ac.kr/handle/2021.oak/7367
https://ulsan-primo.hosted.exlibrisgroup.com/primo-explore/fulldisplay?docid=TN_cdi_proquest_miscellaneous_2457672066&context=PC&vid=ULSAN&lang=ko_KR&search_scope=default_scope&adaptor=primo_central_multiple_fe&tab=default_tab&query=any,contains,Meta-analysis%20of%20CT%20and%20MRI%20for%20differentiation%20of%20autoimmune%20pancreatitis%20from%20pancreatic%20adenocarcinoma&offset=0&pcAvailability=true
Publisher
EUROPEAN RADIOLOGY
Location
오스트리아
Language
영어
ISSN
0938-7994
Citation Volume
31
Citation Number
5
Citation Start Page
3427
Citation End Page
3438
Appears in Collections:
Medicine > Medicine
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