Comparative analysis of ERCP, IDUS, EUS and CT in predicting malignant bile duct strictures

Table 2 Diagnostic indices predicting malignant bile duct stenosis

Index	Diagnostic parameter
	ERCP/IDUS			ETP			IDUS + ETP			EUS			CT
	95%CI			95%CI			95%CI			95%CI			95%CI
All patients
Sensitivity	93%	88-97	126/136	37%	29-45	47/127	94%	90-98	128/136	71%	63-78	96/136	67%	59-75	91/136
Specificity	89%	83-95	87/98	100%	NA	67/67	89%	83-95	87/98	78%	69-86	76/98	82%	74-89	80/98
Accuracy	91%	87-95	213/234	59%	52-66	114/194	92%	88-95	215/234	74%	68-79	172/234	73%	67-79	171/234
Subgroup only considering CCC as a malignancy
Sensitivity	96%	92-100	54/56	42%	29-55	23/55	96%	92-100	54/56	57%	44-70	32/56	73%	62-85	41/56
Specificity	89%	83-95	87/98	100%	NA	67/67	89%	83-95	87/98	78%	69-86	76/98	82%	74-89	80/98
Accuracy	92%	87-96	141/154	74%	66-81	90/122	92%	87-96	141/154	70%	63-77	108/154	79%	72-85	121/154
Subgroup only considering pancreatic carcinoma as a malignancy
Sensitivity	93%	86-100	51/55	26%	14-38	13/50	93%	86-100	51/55	87%	78-96	48/55	65%	53-78	36/55
Specificity	89%	83-95	87/98	100%	NA	67/67	89%	83-95	87/98	78%	69-86	76/98	82%	74-89	80/98
Accuracy	90%	85-95	138/153	68%	60-77	80/117	90%	85-95	138/153	81%	75-87	124/153	76%	69-78	116/153
Subgroup only considering ampullary carcinoma as a malignancy
Sensitivity	84%	68-100	16/19	53%	29-77	9/8	95%	85-100	18/19	68%	48-89	13/19	47%	25-70	9/19
Specificity	89%	83-95	87/98	100%	NA	67/67	89%	83-95	87/98	78%	69-86	76/98	82%	74-89	80/98
Accuracy	88%	82-94	103/117	90%	84-97	76/84	90%	84-95	105/117	76%	68-84	89/117	76%	68-84	89/117

IDUS: Intraductal ultrasound; ETP: Endoscopic transpapillary biopsies; EUS: Endoscopic ultrasound; CT: Computed tomography; NA: Not available.