Xu Fan, Liang Yingying, Guo Wei, Liang Zhiping, Li Liqi, Xiong Yuchao, Ye Guoxi, Zeng Xuwen
Department of Radiology, Guangzhou Red Cross Hospital, Medical College, Jinan University, Guangzhou, China.
Department of Radiology, Guangzhou First People's Hospital, School of Medicine, South China University of Technology, Guangzhou, China.
Front Oncol. 2021 Jul 5;11:637681. doi: 10.3389/fonc.2021.637681. eCollection 2021.
To assess the diagnostic accuracy of diffusion-weighted imaging (DWI) in predicting the malignant potential in patients with intraductal papillary mucinous neoplasms (IPMNs) of the pancreas.
A systematic search of articles investigating the diagnostic performance of DWI for prediction of malignant potential in IPMNs was conducted from PubMed, Embase, and Web of Science from January 1997 to 10 February 2020. QUADAS-2 tool was used to evaluate the study quality. Pooled sensitivity, specificity, diagnostic odds ratio (DOR), positive likelihood ratios (PLR), negative likelihood ratios (NLR), and their 95% confidence intervals (CIs) were calculated. The summary receiver operating characteristic (SROC) curve was then plotted, and meta-regression was also performed to explore the heterogeneity.
Five articles with 307 patients were included. The pooled sensitivity and specificity of DWI were 0.74 (95% CI: 0.65, 0.82) and 0.94 (95% CI: 0.78, 0.99), in evaluating the malignant potential of IPMNs. The PLR was 13.5 (95% CI: 3.1, 58.7), the NLR was 0.27 (95% CI: 0.20, 0.37), and DOR was 50.0 (95% CI: 11.0, 224.0). The area under the curve (AUC) of SROC curve was 0.84 (95% CI: 0.80, 0.87). The meta-regression showed that the slice thickness of DWI (p = 0.02) and DWI parameter (p= 0.01) were significant factors affecting the heterogeneity.
DWI is an effective modality for the differential diagnosis between benign and malignant IPMNs. The slice thickness of DWI and DWI parameter were the main factors influencing diagnostic specificity.
评估弥散加权成像（DWI）在预测胰腺导管内乳头状黏液性肿瘤（IPMN）患者恶性潜能方面的诊断准确性。
于1997年1月至2020年2月10日，在PubMed、Embase和Web of Science上系统检索研究DWI对IPMN恶性潜能预测诊断性能的文章。使用QUADAS - 2工具评估研究质量。计算合并敏感度、特异度、诊断比值比（DOR）、阳性似然比（PLR）、阴性似然比（NLR）及其95%置信区间（CI）。随后绘制总结性受试者工作特征（SROC）曲线，并进行Meta回归以探索异质性。
纳入5篇文章共307例患者。在评估IPMN的恶性潜能时，DWI的合并敏感度和特异度分别为0.74（95%CI：0.65，0.82）和0.94（95%CI：0.78，0.99）。PLR为13.5（95%CI：3.1，58.7），NLR为0.27（95%CI：0.20，0.37），DOR为50.0（95%CI：11.0，224.0）。SROC曲线下面积（AUC）为（95%CI：0.80，0.87）。Meta回归显示，DWI的层厚（p = 0.02）和DWI参数（p = 0.01）是影响异质性的显著因素。
DWI是鉴别良性和恶性IPMN的有效方法。DWI的层厚和DWI参数是影响诊断特异性的主要因素。
