Comparison of standard vs auxiliary (contrast or elastography) endoscopic ultrasound-guided fine needle aspiration/biopsy in solid pancreatic lesions: A meta-analysis

doi:10.5662/wjm.v15.i3.97415

Advanced Search

BPG is committed to discovery and dissemination of knowledge

Home / Archive / Volume 15, Issue 3

This Article

Academic Content and Language Evaluation of This Article

CrossCheck and Google Search of This Article

Academic Rules and Norms of This Article

Citation of this article

Corresponding Author of This Article

Research Domain of This Article

Article-Type of This Article

Open-Access Policy of This Article

Times Cited Counts in Google of This Article

Number of Hits and Downloads for This Article

Total Article Views (32)

All Articles published online

The chart showing PDF series, HTML series, Figures (1-6) series, Tables (1-4) series.

Item

Count

PDF

HTML

Figures (1-6)

Tables (1-4)

Sum=29

Sep 20, 2025 (publication date) through Mar 6, 2025

Times Cited of This Article

Times Cited (0)

Journal Information of This Article

Publication Name

World Journal of Methodology

ISSN

2222-0682

Publisher of This Article

Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA

Meta-Analysis

World J Methodol. Sep 20, 2025; 15(3): 97415
Published online Sep 20, 2025. doi: 10.5662/wjm.v15.i3.97415

Table 1 Baseline characteristics of the studies included in the meta-analysis, mean ± SD/median (range/25^th-75^th percentiles)

Ref.	Country	Study design	Arm	Number of patients	Age	Lesion size, in mm	Lesion location (H/U-B/T)	Contrast	Needle	Suction	Number of passes	ROSE
Hou et al[17]	China	Retrospective	CEH-EUS FNA	58	55.1 ± 11.7	38 ± 12	35/23	SonoVue	22-G	-	3.7 ± 0.9	No
Hou et al[17]	China	Retrospective	EUS-FNA	105	56.2 ± 12.5	39 ± 8.0	65/40	-	22-G	-	3.6 ± 0.8	No
Seicean et al[18]	Romania	Prospective, cross-over	CEH-EUS FNA	51	64 (39-83)	35	31/10	SonoVue	22-G	-	2	No
Seicean et al[18]	Romania	Prospective, cross-over	EUS-FNA	51	64 (39-83)	35	31/10	-	22-G	-	2	No
Sugimoto et al[19]	Japan	RCT	CEH-EUS FNA	20	69.5 ± 10.5	25.0 ± 8.0	13/7	Sonazoid	22-G	DS	1-5	Yes
Sugimoto et al[19]	Japan	RCT	EUS-FNA	20	67.1 ± 9.9	26.5 ± 9.2	13/7	-	22-G or 25-G	DS	1-5	Yes
Facciorusso et al[20]	Italy	Retrospective	CEH-EUS FNA	103	66 ± 6	32 ± 11	71/32	SonoVue	22-G	DS	2.4 ± 0.6	No
Facciorusso et al[20]	Italy	Retrospective	EUS-FNA	103	66 ± 8	32 ± 10	71/32	-	22-G	DS	2.7 ± 0.8	No
Itonaga et al[21]	Japan	Prospective, cross-over	CEH-EUS FNA	93	72.5 (34–89)	25.2 (12-56)	55/38	Sonazoid	22-G	DS	2.6 (2-5)	No
Itonaga et al[21]	Japan	Prospective, cross-over	EUS-FNA	93	72.5 (34–89)	25.2 (12-56)	55/38	-	22-G	DS	2.6 (2-5)	No
Seicean et al[22]	Romania	RCT, cross-over	CEH-EUS FNA	148	64.5 (62.6 – 66.3)	30 (20.8- 35)	103/45	SonoVue	22-G	-	1	No
Seicean et al[22]	Romania	RCT, cross-over	EUS-FNA	148	64.5 (62.6 – 66.3)	30 (20.8- 35)	103/45	-	22-G	-	1	No
Cho et al[23]	South Korea	RCT	CEH-EUS FNA/B	120	66.3 ± 11.8	30.9 ± 2.1	54/66	SonoVue	19- to 25-G	DS	1-5	No
Cho et al[23]	South Korea	RCT	EUS-FNA/B	120	68.3 ± 11.9	33.1 ± 16.4	60/60	-	19- to 25-G	DS	1-5	No
Gheorghiu et al[24]	Romania	Prospective, cross-over	RTE-EUS FNA	60	66.4 ± 10.0	30 (29.5 -35)	44/16	-	22-G	No	1	No
Gheorghiu et al[24]	Romania	Prospective, cross-over	EUS-FNA	60	66.4 ± 10.0	30 (29.5 -35)	44/16	-	22-G	No	1	No
Lai et al[25]	Taiwan	Retrospective	CEH-EUS FNB	48	63.6 ± 12.6	29.5 ± 11.5	29/11/8	Sonazoid	22-G	SSP	2.2 ± 0.7	No
Lai et al[25]	Taiwan	Retrospective	EUS-FNB	85	63.6 ± 12.6	34.8 ± 18.2	39/36/10	-	22-G	SSP	3.6 ± 1.2	No
Kuo et al[26]	Taiwan	RCT	CEH-EUS FNB	59	64.7 ± 11.6	37.5 (28.8-45.9)	30/29	Sonazoid	22-G	No	1-6	Yes
Kuo et al[26]	Taiwan	RCT	EUS-FNB	59	64.1 ± 12.6	37.5 (30.6-46.2)	34/25	-	22-G	No	1-6	Yes

EUS-FNA/B: Endoscopic ultrasound-guided fine-needle aspiration/biopsy; CEH-EUS-FNA/B: Contrast-enhanced harmonic-EUS-FNA/B; RTE-EUS-FNA/B: Real-time elastography EUS-FNA/B; Lesion location (H/U-B/T): Head or uncinate process-body or tail; RCT: Randomized controlled trial; ROSE: Rapid on-site evaluation; DS: Dry suction; SSP: Slow stylet pull.

Table 2 Summary of results of diagnostic test accuracy meta-analysis

Parameters	Standard EUS-FNA/B		EUS-FNA/B with auxiliary techniques
Parameters	Values with 95%CI	Heterogeneity (I²)	Values with 95%CI	Heterogeneity (I²)
Sensitivity	0.82 (0.79-0.85)	89.8%	0.86 (0.83-0.89)	73.6%
Specificity	1.00 (0.96-1.00)	0.0%	1.00 (0.94-1.00)	2.7%
Positive LR	14.42 (5.64-36.90)	0.0%	11.11 (4.30-28.71)	21.6%
Negative LR	0.19 (0.13-0.30)	82.5%	0.17 (0.13-0.22)	40.4%
DOR	105.51 (36.38-305.99)	0.0%	126.87 (44.43-362.28)	0.0%
AUROC	0.97 (0.95-0.98)	-	0.96 (0.94-0.98)	-

LR: Likelihood ratio; DOR: Diagnostic odds ratio; AUROC: Area under the receiver operating characteristic curve; EUS-FNA/B: Endoscopic ultrasound-guided fine-needle aspiration/biopsy.

Table 3 Comparative analysis of endoscopic ultrasound-guided fine-needle aspiration/biopsy with auxiliary vs standard technique with sensitivity analysis

Comparison of EUS-FNA/B with auxiliary vs standard techniques	No. of studies	Relative risk	P value	Tau²
Relative sensitivity
Overall	9	1.04 (0.99-1.09)	0.0828	0.91
Studies with CEH-EUS-FNA/B	8	1.05 (1.00-1.10)	0.0729	1.05
Randomized studies	4	1.00 (0.97-1.03)	0.9006	1.41
Relative specificity
Overall	9	1.00 (1.00-1.01)	0.8123	0.41
Studies with CEH-EUS-FNA/B	8	1.00 (1.00-1.01)	0.8096	8.42
Randomized studies	4	1.01 (0.96-1.06)	0.7840	6.31
				I²
Diagnostic accuracy
Overall	10	1.02 (0.98-1.07)	0.33	50%
Studies with CEH-EUS-FNA/B	9	1.03 (0.98-1.09)	0.23	55%
After single pass	5	1.01 (0.93-1.10)	0.19	35%
Randomized studies	4	0.99 (0.95-1.02)	0.45	0%

EUS-FNA/B: Endoscopic ultrasound-guided fine-needle aspiration/biopsy; CEH-EUS-FNA/B: Contrast-enhanced harmonic-EUS-FNA/B.

Table 4 Grade of evidence table¹

Outcomes	Anticipated absolute effects (95%CI)		Relative effect (95%CI)	No. of patients (studies)	Certainty assessment				Overall certainty of evidence
Outcomes	With standard EUS-FNA/B	With EUS-FNA/B and auxiliary techniques	Relative effect (95%CI)	No. of patients (studies)	Risk of bias	Inconsistency	Indirectness	Imprecision	Overall certainty of evidence
Sensitivity	0.82 (0.79-0.85)	0.86 (0.83-0.89)	RR: 1.04 (0.99-1.09)	1471 (9 studies)	+	+	-	-	Low
Specificity	1.00 (0.96-1.00)	1.00 (0.94-1.00)	RR: 1.00 (0.99-1.01)	1471 (9 studies)	+	+	-	-	Low
Diagnostic accuracy	846 per 1000	17 higher per 1000 (17 lower to 59 more)	RR: 1.02 (0.98-1.07)	1604 (10 studies)	+	+	-	-	Low

¹Population: Patients with a solid pancreatic lesion. Index test: Real-time elastography-endoscopic ultrasound-guided fine-needle aspiration/biopsy/B or Contrast-enhanced harmonic-endoscopic ultrasound-guided fine-needle aspiration/biopsy. Comparator test: Standard Endoscopic ultrasound-guided fine-needle aspiration/biopsy.

EUS-FNA/B: Endoscopic ultrasound-guided fine-needle aspiration/biopsy.

Citation: Rath MM, Anirvan P, Varghese J, Tripathy TP, Patel RK, Panigrahi MK, Giri S. Comparison of standard vs auxiliary (contrast or elastography) endoscopic ultrasound-guided fine needle aspiration/biopsy in solid pancreatic lesions: A meta-analysis. World J Methodol 2025; 15(3): 97415
URL: https://www.wjgnet.com/2222-0682/full/v15/i3/97415.htm
DOI: https://dx.doi.org/10.5662/wjm.v15.i3.97415