Clinical Report: Diagnostic Accuracy of Image-Guided Puncture for Peritoneal Lesions
Overview
This systematic review and meta-analysis evaluated the diagnostic performance of image-guided puncture techniques in differentiating malignant from benign peritoneal lesions. The pooled data from 15 studies demonstrated high sensitivity and specificity, supporting the technique as a safe and minimally invasive diagnostic tool.
Background
Peritoneal lesions can be benign or malignant, often presenting with overlapping imaging features that complicate diagnosis. Conventional imaging modalities such as ultrasound, CT, and MRI have limitations in distinguishing these lesions. Traditional biopsy methods require invasive surgery with associated risks. Image-guided puncture using US, CT, or EUS offers a less invasive alternative with promising diagnostic accuracy.
Data Highlights
Parameter
Range Across Studies
Sensitivity
64% - 98%
Specificity
86% - 100%
Key Findings
Image-guided puncture demonstrated pooled high sensitivity and specificity for differentiating malignant from benign peritoneal lesions.
The technique is less invasive and safer compared to traditional laparotomy or laparoscopy biopsies.
Diagnostic accuracy varied across studies, with sensitivity ranging from 64% to 98% and specificity from 86% to 100%.
Quality assessment using QUADAS-2 indicated generally low risk of bias and good applicability of included studies.
Random-effects meta-analysis accounted for heterogeneity among studies, providing robust pooled estimates.
Clinical Implications
Image-guided puncture should be considered a first-line diagnostic approach for patients with peritoneal lesions due to its minimally invasive nature and high diagnostic accuracy. This technique can reduce the need for more invasive surgical biopsies, thereby minimizing patient morbidity and healthcare costs. Clinicians should be aware of the variability in diagnostic performance and consider complementary clinical and imaging data when interpreting results.
Conclusion
Image-guided puncture is a reliable, safe, and effective diagnostic method for distinguishing malignant from benign peritoneal lesions. Its adoption in clinical practice can improve diagnostic workflows and patient outcomes.
References
Systematic Review and Meta-Analysis 2024 -- Guided Puncture Techniques for Peritoneal Lesions
