Image-guided puncture for differentiating malignant from benign peritoneal lesions: a systematic review and...

Area of Science:

• Medical Imaging
• Oncology
• Gastroenterology

Background:

• Diagnosing peritoneal lesions is challenging due to the complexity and invasiveness of traditional methods like diagnostic laparoscopy.
• Routine imaging examinations often show overlapping features, complicating accurate diagnosis of peritoneal lesions.
• There is a need for accurate, minimally invasive diagnostic tools for peritoneal lesions.

Purpose of the Study:

• To evaluate the diagnostic performance of image-guided puncture in distinguishing malignant from benign peritoneal lesions.
• To compare the accuracy of image-guided puncture with established reference standards like postoperative pathology and diagnostic laparoscopy.

Main Methods:

• A comprehensive literature search was conducted across major medical databases (PubMed, Embase, Web of Science, Cochrane Library, Ovid).
• Diagnostic accuracy was assessed by calculating pooled sensitivity, specificity, diagnostic odds ratio (DOR), and area under the curve (AUC).
• Subgroup analyses were performed based on imaging modality, puncture technique, and study quality (QUADAS-2).

Main Results:

• Fifteen studies including 1208 patients and 1165 peritoneal lesions were analyzed.
• Image-guided puncture showed high pooled sensitivity (93%) and specificity (95%) for differentiating malignant from benign peritoneal lesions.
• The pooled diagnostic odds ratio (DOR) was 149.02, and the area under the curve (AUC) was 0.97, indicating excellent diagnostic performance.

Conclusions:

• Image-guided puncture is a minimally invasive and safe technique with high diagnostic accuracy for peritoneal lesions.
• The diagnostic efficacy is consistent across various imaging modalities, puncture methods, and lesion types.
• This method provides a reliable and less invasive alternative to diagnostic laparoscopy for diagnosing peritoneal lesions.