Surveillance of high-risk individuals for pancreatic cancer with EUS and MRI: A meta-analysis
| Autor: | Kelly E. Diaz, Alan D. Weinberg, Nina Kogekar, Aimee L. Lucas |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
medicine.medical_specialty
Endocrinology Diabetes and Metabolism Endoscopic ultrasonography Adenocarcinoma Endosonography 03 medical and health sciences 0302 clinical medicine Pancreatic cancer Medicine Humans Prospective Studies Prospective cohort study Hepatology medicine.diagnostic_test business.industry Gastroenterology Magnetic resonance imaging medicine.disease Magnetic Resonance Imaging digestive system diseases Pancreatic Neoplasms medicine.anatomical_structure Dysplasia 030220 oncology & carcinogenesis Meta-analysis 030211 gastroenterology & hepatology Radiology business Pancreas |
| Zdroj: | Pancreatology : official journal of the International Association of Pancreatology (IAP) ... [et al.]. 20(8) |
| ISSN: | 1424-3911 |
| Popis: | Background/objectives Consensus guidelines recommend surveillance of high-risk individuals (HRIs) for pancreatic cancer (PC) using endoscopic ultrasonography (EUS) and/or magnetic resonance imaging (MRI). This study aims to assess the yield of PC surveillance programs of HRIs and compare the detection of high-grade dysplasia or T1N0M0 adenocarcinoma by EUS and MRI. Methods The MEDLINE and Embase (Ovid) databases were searched for prospective studies published up to April 11, 2019 using EUS and/or MRI to screen HRIs for PC. Baseline detection of focal pancreatic abnormalities, cystic lesions, solid lesions, high-grade dysplasia or T1N0M0 adenocarcinoma, and all pancreatic adenocarcinoma were recorded. Weighted pooled proportions of outcomes detected were compared between EUS and MRI using random effects modeling. Results A total of 1097 studies were reviewed and 24 were included, representing 2112 HRIs who underwent imaging. The weighted pooled proportion of focal pancreatic abnormalities detected by baseline EUS (0.34, 95% CI 0.30–0.37) was significantly higher (p = 0.006) than by MRI (0.31, 95% CI 0.28–0.33). There were no significant differences between EUS and MRI in detection of other outcomes. The overall weighted pooled proportion of patients with high-grade dysplasia or T1N0M0 adenocarcinoma detected at baseline (regardless of imaging modality) was 0.0090 (95% CI 0.0022–0.016), corresponding to a number-needed-to-screen (NNS) of 111 patients to detect one high-grade dysplasia or T1N0M0 adenocarcinoma. Conclusions Surveillance programs are successful in detecting high-risk precursor lesions. No differences between EUS and MRI were noted in the detection of high-grade dysplasia or T1N0M0 adenocarcinoma, supporting the use of either imaging modality. |
| Databáze: | OpenAIRE |
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