Prospective cohort study comparing transient EUS guided elastography to EUS-FNA for the diagnosis of solid pancreatic mass lesions

Diagnostic utility of endoscopic ultrasonography-elastography in the evaluation of solid pancreatic masses: a meta-analysis and systematic review

“…Seventeen studies were finally selected [4,[7][8][9]16,[19][20][21][22][23][24][25][26][27][28][29][30] ( figure 1 shows the flow chart of the selection process). Only one was a conference abstract [27], the others were all full-texts.…”

“…Characteristics of the selected studies are shown in Table I. Six studies used SH as the diagnostic standard [4,9,22,[26][27][28], 7 studies used SR [7][8][9]16,19,23,27,30], 3 studies used color pattern [20,23,24],and 3 studies used elastic score [21,25,29]. For those using SH, the cut-off values ranged from 62 to 80, and for those using SR, the cut-off values varied from 3.05 to 24.82.…”

“…Their cut-off values were decided by using previous published studies, or the one with the highest accuracy rate based on the receiver operator characteristic (ROC) curves. Four studies also evaluated CE-EUS [4,19,20,22], and 4 studies evaluated EUS-FNA [7,8,19,22].…”

“…There is a special type of SH called neural network, in which the selection of images is automatically done by computer, and selection bias can be reduced to some degree [4]. Another common quantitative method is SR, which compares the SH of two regions of interest, usually the ratio of peripheral tissue and the lesion [7,36]. The methods used and the results in the previously published studies are still in dispute [4,[7][8][9]16], so we made a systematic review and meta-analysis of the published articles based on the different evaluation methods they used.…”

“…Clinical information, biochemical tests, and imaging techniques diagnosis and elastic score, the latter include strain histograms (SH) and strain ratio (SR). The accuracy of EUS-EG in distinguishing solid pancreatic masses has varied greatly in different studies [4,[7][8][9], and several meta-analysis have been published on this issue [10][11][12][13][14][15]. However, the newly added data since 2013 have not been updated [4,[7][8][9]16], and the results should be pooled separately based on each different measurement.…”