Ultrasonography, computed tomography and magnetic resonance imaging for diagnosis and determining resectability of pancreatic adenocarcinoma: a meta-analysis

OBJECTIVE: To compare ultrasonography (US), computed tomography (CT), and magnetic resonance imaging (MRI) in the diagnosis and determination of resectability of pancreatic adenocarcinoma. METHODS: Articles reporting US, CT, or MRI data of patients with known or suspected pancreatic adenocarcinoma and at least 20 patients verified with histopathology, surgical findings, or follow-up were included. A bivariate random effects approach was used to calculate sensitivity and specificity for diagnosis and resectability of pancreatic adenocarcinoma. RESULTS: Sixty-eight articles fulfilled all inclusion criteria. For diagnosis, sensitivities of helical CT, conventional CT, MRI, and US were 91%, 86%, 84%, and 76% and specificities were 85%, 79%, 82%, and 75% respectively. Sensitivities for MRI and US were significantly lower compared with helical CT (P = 0.04 and P = 0.0001). For determining resectability, sensitivities of helical CT, conventional CT, MRI, and US were 81%, 82%, 82, and 83% and specificities were 82%, 76%, 78%, and 63% respectively. Specificity of US was significantly lower compared with helical CT (P = 0.011). CONCLUSIONS: Helical CT is preferable as an imaging modality for the diagnosis and determination of resectability of pancreatic adenocarcinoma.