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

Aim: The accuracy for endoscopic ultrasonography-elastography ( EUS-EG) in the evaluation of solid pancreatic masses varies greatly and the pooled results have not been updated since 2013. Also, there still lack a comprehensive comparison among EUS-EG, contrast-enhanced EUS (CE-EUS), and EUS-guided fine needle aspiration (EUS-FNA). Material and methods: A thorough search was made for diagnostic trials investigating the role of EUS-EG in solid pancreatic masses. Meta-Disc was used to calculate the pooled sensitivity, specificity, diagnostic odds ratio and summary receiver operator characteristics. Results: Finally, 17 studies (1537 patients, 1544 lesions) were selected. The pooled sensitivity and specificity for qualitative methods were 0.97 (95% CI, 0.95-0.99) and 0.67 (95% CI, 0.59-0.74), respectively; the pooled sensitivity and specificity for strain histograms were 0.97 (95% CI, 0.95-0.98) and 0.67(95% CI, 0.61-0.73), respectively; the pooled sensitivity and specificity for strain ratio were 0.98 (95% CI, 0.96-0.99) and 0.62 (95% CI, 0.56-0.68), respectively; the pooled sensitivity and specificity for CE-EUS were 0.90 (95% CI, 0.83-0.95) and 0.76 (95% CI, 0.67-0.84), respectively; the pooled sensitivity and specificity for EUS-FNA were 0.84 (95% CI, 0.77-0.90) and 0.96(95% CI, 0.88-1.00), respectively. Conclusion: EUS-EG is reliable for distinguishing solid pancreatic masses; the sensitivity and specificity for different diagnostic methods were very close. Both EUS-EG and CE-EUS can be valuable complementary supplements for EUS-FNA.