HPB SO16 - The accuracy of various diagnostic methods in differentiating between malignant and benign hilar strictures - a systematic review

Abstract

Abstract Background It is difficult to distinguish benign and malignant hilar strictures and surgical resection is associated with high rates of morbidity and mortality. Therefore, more accurate diagnostic methods are required. The aim of this systematic review was to investigate the sensitivity and specificity of current diagnostic strategies in differentiating between malignant and benign hilar strictures. Method This systematic review was conducted in line with the PRISMA guidelines. A comprehensive literature search was completed using PUBMED and Medline databases to identify original research studies reporting sensitivity and specificity of various diagnostic methods for hilar strictures. Results A total of 653 papers were identified and after review 20 publications were included in the analysis, comprising 1,824 patients. (18)F-FDG PET/CT appeared in 6 studies with sensitivity range 69.6%-92.3%, followed by cytology identified in 5 studies with sensitivity 32.9%-89% and specificity 89%-100%. Finally, CEA marker was utilized in 3 studies with sensitivity 33%-72% and specificity 84%-90%. Conclusion Due to wide variation in reported accuracy of diagnostic tests in suspected hilar CCA, a prospective observational study is warranted to determine the optimal strategy and understand the current error rate and where improvements may be made.