Identification of cancers and gastroenterological diseases can be challenging, as clinicians must ensure the process for identification is accurate while minimizing complications and ensuring sustainability associated with procedures. In addition, for those with cancer, accurate staging is vital for guiding the most appropriate therapy.

There are a number of minimally invasive imaging strategies that may be used for identifying and staging different types of cancers, as well as identifying gastroentological disease. Examples of imaging strategies include computed tomography (CT), magnetic resonance imaging (MRI), positron emission tomography (PET), endoscopic retrograde cholangiopancreatography (ERCP), and endoscopic ultrasound (EUS). Each strategy is associated with differing accuracy for different diseases, as well as when comparing diagnosis and staging of illness. In addition, each strategy is associated with other benefits and limitations. For example, EUS is often less expensive and more readily available relative to other imaging modalities like CT, PET and MRI, but CT, PET and MRI allow for visualization of a larger area compared with EUS. Also, the amount of radiation exposure, and need for contrast media, differs between each modality. Lastly, these imaging modalities may be complementary to one another, for example, using EUS to minimize exposure to the more invasive ERCP in people with acute biliary pancreatitis.

The purpose of this review was to evaluate the evidence for clinical effectiveness, safety, and cost effectiveness of EUS compared to other imaging modalities including CT, MRI, PET, or ERCP.

Contents

• CONTEXT AND POLICY ISSUES
• RESEARCH QUESTIONS
• KEY FINDINGS
• METHODS
  • Literature Search Strategy
  • Selection Criteria and Methods
  • Exclusion Criteria
  • Critical Appraisal of Individual Studies
• SUMMARY OF EVIDENCE
  • Quantity of Research Available
  • Summary of Study Characteristics
  • Summary of Critical Appraisal
  • Summary of Findings
• LIMITATIONS
• CONCLUSIONS AND IMPLICATIONS FOR DECISION OR POLICY MAKING
• REFERENCES
• APPENDIX 1 Selection of Included Studies
• APPENDIX 2 Characteristics of the included meta-analyses, systematic reviews, and randomized controlled trials
• APPENDIX 3 Characteristics of the included economic analysis
• APPENDIX 4 Critical appraisal of all included studies
• APPENDIX 5 Main study findings and authors’ conclusions

Disclaimer: The Rapid Response Service is an information service for those involved in planning and providing health care in Canada. Rapid responses are based on a limited literature search and are not comprehensive, systematic reviews. The intent is to provide a list of sources and a summary of the best evidence on the topic that CADTH could identify using all reasonable efforts within the time allowed. Rapid responses should be considered along with other types of information and health care considerations. The information included in this response is not intended to replace professional medical advice, nor should it be construed as a recommendation for or against the use of a particular health technology. Readers are also cautioned that a lack of good quality evidence does not necessarily mean a lack of effectiveness particularly in the case of new and emerging health technologies, for which little information can be found, but which may in future prove to be effective. While CADTH has taken care in the preparation of the report to ensure that its contents are accurate, complete and up to date, CADTH does not make any guarantee to that effect. CADTH is not liable for any loss or damages resulting from use of the information in the report.