Preoperative vascular evaluation with computed tomography and magnetic resonance imaging for pancreatic cancer: A meta-analysis

被引:31
作者
Zhang, YaoJun [1 ,3 ]
Huang, Jia [1 ,2 ]
Chen, MinShan [3 ]
Jiao, Long R. [1 ]
机构
[1] Univ London Imperial Coll Sci Technol & Med, Dept Surg & Canc, London W12 0NN, England
[2] Sun Yat Sen Univ, Affiliated Hosp 1, Dept Obstet & Gynaecol, Guangzhou 510089, Guangdong, Peoples R China
[3] Sun Yat Sen Univ, State Key Lab Oncol So China, Ctr Canc, Dept Hepatobiliary Surg, Guangzhou 510060, Guangdong, Peoples R China
关键词
Computed tomography; Magnetic resonance imaging; Pancreatic cancer; Vascular invasion; Sensitivity and specificity; HELICAL CT; MR CHOLANGIOPANCREATOGRAPHY; PERIAMPULLARY CANCERS; VEIN RESECTION; PORTAL-VEIN; INVASION; ADENOCARCINOMA; RESECTABILITY; ANGIOGRAPHY; CARCINOMA;
D O I
10.1016/j.pan.2012.03.057
中图分类号
R57 [消化系及腹部疾病];
学科分类号
摘要
Objectives: Vascular invasion (VI) is the most important factor in assessing operability for pancreatic cancer. The accuracy of preoperative vascular staging with computed tomography (CT) and magnetic resonance imaging (MRI) was examined using meta-analysis. Methods: Published articles in pancreatic cancer comparing diagnostic accuracy of CT with MRI for VI confirmed on histology were searched from MEDLINE, EMBASE and ISI Web of Science databases. Pooled sensitivity, specificity, likelihood ratio, summary receiver operating characteristic (SROC) curve and area under curve (AUC) were analysed by SPSS 13.0 and Revmen 5.1. Results: Eight studies (n = 296) met the inclusion criteria. The pooled sensitivity of CT and MRI in diagnosing VI was 71% (95% CI, 64-78) and 67% (95% CI, 59-74), pooled specificity 92% (95% CI, 89-95) and 94% (95% CI, 91-96), positive likelihood ratio 6.33 (95% CI. 4.51-8.87) and 6.58 (95% CI, 4.62-9.37), negative likelihood ratio 0.34 (95% CI, 0.27-0.43) and 0.38 (95% CI, 0.30-0.47), and AUCs 0.87 and 0.76 (p = 0.63), respectively. There was no significant difference between CT and MRI for preoperative diagnosis of VI. Subgroup analysis of 4 studies (n = 143) showed no significant difference between CT and MRI in preoperative diagnosis of venous or arterial invasion (p = 0.73 and p = 0.81, respectively). When CT was compared with MRA in 3 studies (n = 110), again there was no significant difference for preoperative staging of VI (p = 0.54). Conclusions: Both CT and MRI are underreporting vascular invasion preoperatively in pancreatic cancer. MRA does not add an additional information on vascular staging when compared with CT and MRI. Copyright (C) 2012, IAP and EPC. Published by Elsevier India, a division of Reed Elsevier India Pvt. Ltd. All rights reserved.
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收藏
页码:227 / 233
页数:7
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