Diagnostic value of diffusion-weighted magnetic resonance imaging (DWI) compared to FDG PET/CT for pancreatic malignancy: a meta-analysis using a hierarchical regression model1
Journal of Gastroenterology and Hepatology,  Clinical Article

Wu LM et al. – Positron emission tomography/compute tomography (PET/CT) was a high sensitive and diffusion–weighted magnetic resonance imaging (DWI) was a high specific modality in diagnosing patients with pancreatic malignancy. PET/CT and DWI could play different roles in diagnosing pancreatic carcinoma. Enhanced PET/CT seems to be superior to unenhanced PET/CT.

Methods
  • The authors performed a meta-analysis of all available studies of the diagnostic performance of DWI and PET/CT for pancreatic malignancy.
  • MEDLINE, EMBASE, Cochrane library and some other databases were searched for initial studies.
  • They determined sensitivities and specificities across studies, calculated positive and negative likelihood ratios (LR+ and LR -), and constructed summary receiver operating characteristic curves using hierarchical regression models.

Results
  • Across 16 studies with 804 patients, PET/CT sensitivity was 0.87 (95%CI, 0.82, 0.81) and specificity was 0.83 (95%CI, 0.71, 0.91).
  • Overall, LR+ was 5.84 (95% CI, 4.59, 7.42) and LR- was 0.24 (95% CI, 0.17, 0.33).
  • DWI sensitivity was 0.85 (95%CI, 0.74, 0.92) and specificity was 0.91 (95%CI, 0.71, 0.98).
  • LR+ was 5.84 (95% CI, 4.59, 7.42) and LR- was 0.24 (95% CI, 0.17, 0.33).
  • In subgroup analysis, the sensitivity of enhanced versus unenhanced PET/CT in the detection of pancreatic cancer was 0.91 (95%CI, 0.86, 0.96) versus 0.84 (95%CI, 0.78, 0.90) (P>0.05), the specificity 0.88 (95%CI, 0.73, 1.00) versus 0.81 (95%CI, 0.69, 0.94) (P>0.05).

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