Endoscopic ultrasound

It's accuracy in evaluating mediastinal lymphadenopathy? A meta-analysis and systematic review

Srinivas R. Puli, Jyotsna Batapati Krishna Reddy, Matthew L. Bechtold, Jamal A. Ibdah, Daphne Antillon, Shailender Singh, Mojtaba Olyaee, Mainor R. Antillon

Research output: Contribution to journalReview article

59 Citations (Scopus)

Abstract

Aim: To evaluate the accuracy of endoscopic ultrasound (EUS), EUS-fine needle aspiration (FNA) in evaluating mediastinal lymphadenopathy. Methods: Only EUS and EUS-FNA studies confirmed by surgery or with appropriate follow-up were selected. Articles were searched in Medline, Pubmed, and Cochrane control trial registry. Only studies from which a 2 × 2 table could be constructed for true positive, false negative, false positive and true negative values were included. Two reviewers independently searched and extracted data. The differences were resolved by mutual agreement. Meta-analysis for the accuracy of EUS was analyzed by calculating pooled estimates of sensitivity, specificity, likelihood ratios, and diagnostic odds ratios. Pooling was conducted by both Mantel-Haenszel method (fixed effects model) and DerSimonian Laird method (random effects model). The heterogeneity of studies was tested using Cochran's Q test based upon inverse variance weights. Results: Data was extracted from 76 studies (n = 9310) which met the inclusion criteria. Of these, 44 studies used EUS alone and 32 studies used EUS-FNA. FNA improved the sensitivity of EUS from 84.7% (95% CI: 82.9-86.4) to 88.0% (95% CI: 85.8-90.0). With FNA, the specificity of EUS improved from 84.6% (95% CI: 83.2-85.9) to 96.4% (95% CI: 95.3-97.4). The P for chi-squared heterogeneity for all the pooled accuracy estimates was > 0.10. Conclusion: EUS is highly sensitive and specific for the evaluation of mediastinal lymphadenopathy and FNA substantially improves this. EUS with FNA should be the diagnostic test of choice for evaluating mediastinal lymphadenopathy.

Original languageEnglish (US)
Pages (from-to)3028-3037
Number of pages10
JournalWorld Journal of Gastroenterology
Volume14
Issue number19
DOIs
StatePublished - May 21 2008
Externally publishedYes

Fingerprint

Fine Needle Biopsy
Meta-Analysis
Lymphadenopathy
Routine Diagnostic Tests
PubMed
Registries
Odds Ratio
Weights and Measures
Sensitivity and Specificity

Keywords

  • EUS-fine needle aspiration
  • Endoscopic ultrasound
  • Mediastinal lymphadenopathy

ASJC Scopus subject areas

  • Gastroenterology

Cite this

Endoscopic ultrasound : It's accuracy in evaluating mediastinal lymphadenopathy? A meta-analysis and systematic review. / Puli, Srinivas R.; Reddy, Jyotsna Batapati Krishna; Bechtold, Matthew L.; Ibdah, Jamal A.; Antillon, Daphne; Singh, Shailender; Olyaee, Mojtaba; Antillon, Mainor R.

In: World Journal of Gastroenterology, Vol. 14, No. 19, 21.05.2008, p. 3028-3037.

Research output: Contribution to journalReview article

Puli, Srinivas R. ; Reddy, Jyotsna Batapati Krishna ; Bechtold, Matthew L. ; Ibdah, Jamal A. ; Antillon, Daphne ; Singh, Shailender ; Olyaee, Mojtaba ; Antillon, Mainor R. / Endoscopic ultrasound : It's accuracy in evaluating mediastinal lymphadenopathy? A meta-analysis and systematic review. In: World Journal of Gastroenterology. 2008 ; Vol. 14, No. 19. pp. 3028-3037.
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abstract = "Aim: To evaluate the accuracy of endoscopic ultrasound (EUS), EUS-fine needle aspiration (FNA) in evaluating mediastinal lymphadenopathy. Methods: Only EUS and EUS-FNA studies confirmed by surgery or with appropriate follow-up were selected. Articles were searched in Medline, Pubmed, and Cochrane control trial registry. Only studies from which a 2 × 2 table could be constructed for true positive, false negative, false positive and true negative values were included. Two reviewers independently searched and extracted data. The differences were resolved by mutual agreement. Meta-analysis for the accuracy of EUS was analyzed by calculating pooled estimates of sensitivity, specificity, likelihood ratios, and diagnostic odds ratios. Pooling was conducted by both Mantel-Haenszel method (fixed effects model) and DerSimonian Laird method (random effects model). The heterogeneity of studies was tested using Cochran's Q test based upon inverse variance weights. Results: Data was extracted from 76 studies (n = 9310) which met the inclusion criteria. Of these, 44 studies used EUS alone and 32 studies used EUS-FNA. FNA improved the sensitivity of EUS from 84.7{\%} (95{\%} CI: 82.9-86.4) to 88.0{\%} (95{\%} CI: 85.8-90.0). With FNA, the specificity of EUS improved from 84.6{\%} (95{\%} CI: 83.2-85.9) to 96.4{\%} (95{\%} CI: 95.3-97.4). The P for chi-squared heterogeneity for all the pooled accuracy estimates was > 0.10. Conclusion: EUS is highly sensitive and specific for the evaluation of mediastinal lymphadenopathy and FNA substantially improves this. EUS with FNA should be the diagnostic test of choice for evaluating mediastinal lymphadenopathy.",
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T2 - It's accuracy in evaluating mediastinal lymphadenopathy? A meta-analysis and systematic review

AU - Puli, Srinivas R.

AU - Reddy, Jyotsna Batapati Krishna

AU - Bechtold, Matthew L.

AU - Ibdah, Jamal A.

AU - Antillon, Daphne

AU - Singh, Shailender

AU - Olyaee, Mojtaba

AU - Antillon, Mainor R.

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N2 - Aim: To evaluate the accuracy of endoscopic ultrasound (EUS), EUS-fine needle aspiration (FNA) in evaluating mediastinal lymphadenopathy. Methods: Only EUS and EUS-FNA studies confirmed by surgery or with appropriate follow-up were selected. Articles were searched in Medline, Pubmed, and Cochrane control trial registry. Only studies from which a 2 × 2 table could be constructed for true positive, false negative, false positive and true negative values were included. Two reviewers independently searched and extracted data. The differences were resolved by mutual agreement. Meta-analysis for the accuracy of EUS was analyzed by calculating pooled estimates of sensitivity, specificity, likelihood ratios, and diagnostic odds ratios. Pooling was conducted by both Mantel-Haenszel method (fixed effects model) and DerSimonian Laird method (random effects model). The heterogeneity of studies was tested using Cochran's Q test based upon inverse variance weights. Results: Data was extracted from 76 studies (n = 9310) which met the inclusion criteria. Of these, 44 studies used EUS alone and 32 studies used EUS-FNA. FNA improved the sensitivity of EUS from 84.7% (95% CI: 82.9-86.4) to 88.0% (95% CI: 85.8-90.0). With FNA, the specificity of EUS improved from 84.6% (95% CI: 83.2-85.9) to 96.4% (95% CI: 95.3-97.4). The P for chi-squared heterogeneity for all the pooled accuracy estimates was > 0.10. Conclusion: EUS is highly sensitive and specific for the evaluation of mediastinal lymphadenopathy and FNA substantially improves this. EUS with FNA should be the diagnostic test of choice for evaluating mediastinal lymphadenopathy.

AB - Aim: To evaluate the accuracy of endoscopic ultrasound (EUS), EUS-fine needle aspiration (FNA) in evaluating mediastinal lymphadenopathy. Methods: Only EUS and EUS-FNA studies confirmed by surgery or with appropriate follow-up were selected. Articles were searched in Medline, Pubmed, and Cochrane control trial registry. Only studies from which a 2 × 2 table could be constructed for true positive, false negative, false positive and true negative values were included. Two reviewers independently searched and extracted data. The differences were resolved by mutual agreement. Meta-analysis for the accuracy of EUS was analyzed by calculating pooled estimates of sensitivity, specificity, likelihood ratios, and diagnostic odds ratios. Pooling was conducted by both Mantel-Haenszel method (fixed effects model) and DerSimonian Laird method (random effects model). The heterogeneity of studies was tested using Cochran's Q test based upon inverse variance weights. Results: Data was extracted from 76 studies (n = 9310) which met the inclusion criteria. Of these, 44 studies used EUS alone and 32 studies used EUS-FNA. FNA improved the sensitivity of EUS from 84.7% (95% CI: 82.9-86.4) to 88.0% (95% CI: 85.8-90.0). With FNA, the specificity of EUS improved from 84.6% (95% CI: 83.2-85.9) to 96.4% (95% CI: 95.3-97.4). The P for chi-squared heterogeneity for all the pooled accuracy estimates was > 0.10. Conclusion: EUS is highly sensitive and specific for the evaluation of mediastinal lymphadenopathy and FNA substantially improves this. EUS with FNA should be the diagnostic test of choice for evaluating mediastinal lymphadenopathy.

KW - EUS-fine needle aspiration

KW - Endoscopic ultrasound

KW - Mediastinal lymphadenopathy

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