Endorectal ultrasound with elastography for differentiating benign and malignant rectal tumors: a systematic review and meta-analysis.

BACKGROUND

Timely and precise diagnosis of rectal tumors is pivotal for improving patient outcomes. Despite advances in imaging technologies, differentiating benign adenomas from early-stage rectal cancer remains a significant challenge. The aim of this study was to assess the effectiveness of endorectal ultrasound (ERUS) elastography in differentiating rectal adenomas from cancer.

METHODS

In accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, a comprehensive search of the PubMed, Embase, and Cochrane databases was performed to identify studies that used ERUS elastography to assess rectal adenomas and cancer. A random effects model was employed to pool the sensitivity, specificity, and diagnostic odds ratio (DOR) for ERUS elastography in the diagnosis of rectal tumors.

RESULTS

Ten studies encompassing a total of 722 patients with rectal tumors were included in this meta-analysis. The pooled sensitivity, specificity, positive likelihood ratio (PLR), negative likelihood ratio (NLR), and DOR of ERUS elastography for distinguishing benign from malignant rectal tumors were 93% (95% confidence intervals (CI), 88%-96%), 86% (95% CI, 78%-92%), 6.71 (95% CI, 4.14-10.86), 0.08 (95% CI, 0.05-0.14), and 84 (95% CI, 38-186), respectively. The summary receiver operating characteristic (SROC) curve demonstrated an area under the curve (AUC) of 0.95 (95% CI, 0.93-0.97).

CONCLUSION

ERUS elastography greatly enhances diagnostic precision by distinguishing rectal adenomas from cancer, providing an effective approach to differentiate benign from malignant rectal lesions.