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• W1967858903 abstract "Background: To evaluate if advancing technology has affected the accuracy of endoscopic ultrasound (EUS) in nodal staging of esophageal cancers. We analyzed relevant EUS studies into three time periods to standardize the change in EUS technology and the change in EUS criteria for nodal invasion. These time periods were 1986 to 1994, 1995 to 1999, and 2000 to 2006. Aim: To evaluate the influence of advancing technology on the accuracy of EUS in N staging of esophageal cancers. Method:Study Selection Criteria: Only EUS studies confirmed by surgery were selected. EUS criteria used for nodal invasion were: larger than one centimeter, hypoechoic, and round instead of elliptical. Only studies from which a 2 × 2 table could be constructed for true positive, false negative, false positive, and true negative values were included. Data collection & extraction: Articles were searched in Medline, Pubmed, Ovid journals, CINH, old Medline, Medline non-indexed citations, and Cochrane control trial registry. Two reviewers independently searched and extracted data. The differences were resolved by mutual agreement. 2 × 2 tables were constructed with the data extracted from each study. Statistical Method: 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: Initial search identified 2610 referenced articles, in which 360 relevant articles were selected and reviewed. Data was extracted from 44 studies (N = 4398) that met the inclusion criteria. Pooled estimates for these time periods are shown in table 1. All the pooled estimates, calculated by fixed and random effect models, were similar. The p for chi-squared heterogeneity for all the pooled accuracy estimates was >0.05. Conclusion: EUS is a good imaging tool to evaluate nodal metastasis of esophageal cancers. This meta-analysis shows that EUS has a high specificity and sensitivity but these capabilities have not improved over time. Advancements in EUS technology and in diagnostic criteria are needed to increase the accuracy for nodal staging of esophageal cancers. Table 1Pooled diagnostic accuracy estimates of EUS for different time periods with 95% confidence intervals Time period No of studies Pooled sensitivity Pooled specificity Pooled positive likelihood ratio Pooled negative likelihood ratio Pooled diagnostic odds ratio 1986 to 1994 17 88.0% (85.4-90.2) 85.2% (83.4-86.9) 3.6 (2.4-5.4) 0.2 (0.1-0.3) 27.6 (14.6-52.4) 1995 to 1999 17 82.6% (78.0-85.9) 84.4% (81.6-86.9) 3.0 (2.1-4.5) 0.3 (0.2-0.4) 14.8 (7.5-29.3) 1995 to 1999 2000 to 2005 10 81.6% (77.8-85.1) 82.4% (78.2-86.1) 3.4 (2.2-5.3) 0.3 (0.2-0.4) 14.9 (6.7-33.1) Open table in a new tab" @default.
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• W1967858903 date "2007-04-01" @default.
• W1967858903 modified "2023-10-17" @default.
• W1967858903 title "The Influence of Advancing Technology in Endoscopic Ultrasound On the Accuracy of Nodal Staging in Esophageal Cancers: A Meta-Analysis and Systematic Review" @default.
• W1967858903 doi "https://doi.org/10.1016/j.gie.2007.03.359" @default.
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