Published online Jun 21, 2013. doi: 10.3748/wjg.v19.i23.3678
Revised: April 6, 2013
Accepted: April 13, 2013
Published online: June 21, 2013
AIM: To detect pancreatic neuroendocrine tumors (PNETs) has been varied. This study is undertaken to evaluate the accuracy of endoscopic ultrasound (EUS) in detecting PNETs.
METHODS: Only EUS studies confirmed by surgery or appropriate follow-up were selected. Articles were searched in Medline, Ovid journals, Medline nonindexed citations, and Cochrane Central Register of Controlled Trials and Database of Systematic Reviews. Pooling was conducted by both fixed and random effects model).
RESULTS: Initial search identified 2610 reference articles, of these 140 relevant articles were selected and reviewed. Data was extracted from 13 studies (n = 456) which met the inclusion criteria. Pooled sensitivity of EUS in detecting a PNETs was 87.2% (95%CI: 82.2-91.2). EUS had a pooled specificity of 98.0% (95%CI: 94.3-99.6). The positive likelihood ratio of EUS was 11.1 (95%CI: 5.34-22.8) and negative likelihood ratio was 0.17 (95%CI: 0.13-0.24). The diagnostic odds ratio, the odds of having anatomic PNETs in positive as compared to negative EUS studies was 94.7 (95%CI: 37.9-236.1). Begg-Mazumdar bias indicator for publication bias gave a Kendall’s tau value of 0.31 (P = 0.16), indication no publication bias. The P for χ2 heterogeneity for all the pooled accuracy estimates was > 0.10.
CONCLUSION: EUS has excellent sensitivity and specificity to detect PNETs. EUS should be strongly considered for evaluation of PNETs.
Core tip: The published data on the diagnostic accuracy of endoscopic ultrasound (EUS) for detection of pancreatic neuroendocrine tumors is varied. We conducted a comprehensive review of the published literature to assess the diagnostic accuracy of EUS in this setting. Our systematic review and meta-analysis has demonstrated an excellent sensitivity and specificity of EUS in this setting compared to previously published literature of other imaging modalities such as transabdominal ultrasound, computed tomography, and magnetic resonance imaging.