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Diagnostic accuracy of cross-sectional and endoscopic imaging in ampullary tumours: systematic review

de Wilde, Anouk J; de Jong, Evelien JM; Gurusamy, Kurinchi S; Abu Hilal, Mohammad; Besselink, Marc G; Dewulf, Maxime JL; Geurts, Sandra ME; ... Bouwense, Stefan AW; + view all (2024) Diagnostic accuracy of cross-sectional and endoscopic imaging in ampullary tumours: systematic review. British Journal of Surgery , 111 (1) pp. 1-8. 10.1093/bjs/znad432. Green open access

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Abstract

BACKGROUND: Differentiation between adenomas and carcinomas of the ampulla of Vater is crucial for therapy and prognosis. This was a systematic review of the literature on the accuracy of diagnostic modalities used to differentiate between benign and malignant ampullary tumours. METHODS: A literature search was conducted in PubMed, Embase, CINAHL, and the Cochrane Library. Studies were included if they reported diagnostic test accuracy information among benign and malignant ampullary tumours, and used pathological diagnosis as the reference standard. Risk of bias was assessed using Quality Assessment on Diagnostic Accuracy Studies (QUADAS) 2 and QUADAS-C. RESULTS: Ten studies comprising 397 patients were included. Frequently studied modalities were (CT; 2 studies), endoscopic ultrasonography (EUS; 3 studies), intraductal ultrasonography (IDUS; 2 studies), and endoscopic forceps biopsy (3 studies). For CT, the reported sensitivity for detecting ampullary carcinoma was 44 and 95%, and the specificity 58 and 60%. For EUS, the sensitivity ranged from 63 to 89% and the specificity between 50 and 100%. A sensitivity of 88 and 100% was reported for IDUS, with a specificity of 75 and 93%. For forceps biopsy, the sensitivity ranged from 20 to 91%, and the specificity from 75 to 86%. The overall risk of bias was scored as moderate to poor. Data were insufficient for meta-analysis. CONCLUSION: To differentiate benign from malignant ampullary tumours, EUS and IDUS seem to be the best diagnostic modalities. Sufficient high-quality evidence, however, is lacking.

Type: Article
Title: Diagnostic accuracy of cross-sectional and endoscopic imaging in ampullary tumours: systematic review
Location: England
Open access status: An open access version is available from UCL Discovery
DOI: 10.1093/bjs/znad432
Publisher version: https://doi.org/10.1093/bjs/znad432
Language: English
Additional information: © The Author(s) 2024. Published by Oxford University Press on behalf of BJS Foundation Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/).
Keywords: Humans, Biopsy, Carcinoma, Cross-Sectional Studies, Endoscopy, Endosonography
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Surgery and Interventional Sci
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Surgery and Interventional Sci > Department of Surgical Biotechnology
URI: https://discovery.ucl.ac.uk/id/eprint/10186114
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