Surveillance of high-risk individuals for pancreatic cancer with EUS and MRI: A meta-analysis |
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| Affiliation: | 1. Department of Medicine, Icahn School of Medicine at Mount Sinai, 1 Gustave L. Levy Place, Box 1060, New York, NY, 10029, USA;2. Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, 1 Gustave L. Levy Place, New York, NY, 10029, USA;3. Division of Gastroenterology, Icahn School of Medicine at Mount Sinai, 1 Gustave L. Levy Place, Box 1060, New York, NY, 10029, USA;1. Division of Nuclear Medicine and Translational Imaging, Department of Medical Imaging, Faculty of Medicine, University of Debrecen, Hungary;2. Doctoral School of Clinical Medicine, Faculty of Medicine, University of Debrecen, Nagyerdei St. 98, H-4032 Debrecen, Hungary;3. Gyula Petrányi Doctoral School of Allergy and Clinical Immunology, Faculty of Medicine, University of Debrecen, Nagyerdei St. 98, H-4032 Debrecen, Hungary;4. Eötvös Loránd University, Faculty of Science, Institute of Chemistry, Budapest, Hungary;5. Scanomed LTD, Nagyerdei St. 98, H-4032 Debrecen, Hungary;6. MTA-ELTE, Research Group of Peptide Chemistry, Hungarian Academy of Sciences, Eötvös L. University, Budapest, Hungary;1. Department of Radiology, Harbin Medical University Cancer Hospital, 150 Haping Road, Harbin 150010, Heilongjiang, China;2. School of Technology, Harbin University, 109 Zhongxing Street, Harbin 150010, Heilongjiang, China;3. Department of Medical Oncology, Harbin Medical University Cancer Hospital, 150 Haping Road, Harbin 150010, Heilongjiang, China;1. Department of Neurosurgery, St. George Hospital, Kogarah, New South Wales, Australia;2. Faculty of Medicine, University of Sydney, Camperdown, New South Wales, Australia;3. School of Medicine, University of New South Wales, Sydney, New South Wales, Australia;4. Faculty of Medicine, University of New South Wales, Sydney, New South Wales, Australia;1. New York University Langone Health Comprehensive Epilepsy Center, New York, NY, USA;2. Northwell Health Epilepsy Program, New York, NY, USA |
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| Abstract: | Background/objectivesConsensus 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.MethodsThe 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.ResultsA 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.ConclusionsSurveillance 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. |
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| Keywords: | Early detection of cancer Familial pancreatic carcinoma Pancreas Tumor |
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