{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T00:08:43Z","timestamp":1789430923218,"version":"build-2803163510"},"reference-count":40,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,6,26]],"date-time":"2026-06-26T00:00:00Z","timestamp":1782432000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["82203452"],"award-info":[{"award-number":["82203452"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Oncol."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Primary small-bowel tumors are uncommon and frequently present with non-specific symptoms. Timely and accurate diagnosis relies on a range of radiologic and endoscopy-based modalities, yet their comparative diagnostic performance remains uncertain.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We performed a systematic review and diagnostic test accuracy meta-analysis. PubMed, Embase, CNKI, and Wanfang databases were searched from inception to August 31, 2025, and the reference lists of included studies and relevant reviews were hand-searched. Two reviewers independently screened studies, extracted data, and assessed the risk of bias using the QUADAS-2 tool. To avoid unit-of-analysis errors, the primary analysis used a de-duplicated dataset with one representative arm per study cohort according to a prespecified hierarchy: the primary or original\/consensus reading reported by the source article, then the arm with the largest analyzable 2\u00d72 denominator, and finally the estimate closest to the within-study median diagnostic odds ratio if ties remained. Pooled sensitivity and specificity were estimated using hierarchical bivariate random-effects models, while alternative arms were retained for sensitivity analyses.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Twenty-one studies met the eligibility criteria and were included in the quantitative synthesis. The overall pooled sensitivity was 0.91 (95% CI: 0.87-0.93) and specificity was 0.88 (95% CI: 0.78-0.94), with an area under the summary receiver operating characteristic curve of 0.95 (95% CI: 0.93-0.97). Between-study heterogeneity was substantial. In modality-stratified analyses, dedicated enterography techniques (magnetic resonance enterography and computed tomography enterography) demonstrated the highest comprehensive diagnostic accuracy, outperforming conventional contrast-enhanced CT and functional imaging.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Contemporary imaging modalities exhibit high overall diagnostic performance for primary small-bowel tumors. Enterography-based cross-sectional imaging yielded the most favorable point estimates, although confidence intervals overlapped with those of conventional CT. These findings support CTE and MRE as strong diagnostic options within a multimodality pathway rather than proving clear statistical superiority.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Systematic review registration<\/jats:title>\n                    <jats:p>\n                      <jats:ext-link>https:\/\/www.crd.york.ac.uk\/PROSPERO\/<\/jats:ext-link>\n                      , identifier CRD420251144585.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fonc.2026.1842330","type":"journal-article","created":{"date-parts":[[2026,6,26]],"date-time":"2026-06-26T04:33:29Z","timestamp":1782448409000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Diagnostic accuracy of imaging modalities for primary small-bowel tumors: a systematic review and diagnostic test accuracy meta-analysis"],"prefix":"10.3389","volume":"16","author":[{"given":"Qi","family":"Xia","sequence":"first","affiliation":[{"name":"Department of General Surgery II, The First People\u2019s Hospital of Daishan County","place":["Daishan, Zhejiang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qinghai","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Radiology, The Second Affiliated Hospital, Zhejiang University School of Medicine","place":["Hangzhou, Zhejiang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chao","family":"Ding","sequence":"additional","affiliation":[{"name":"Department of Hepatopancreatobiliary Surgery, The Second Affiliated Hospital, Zhejiang University School of Medicine","place":["Hangzhou, Zhejiang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jun","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology Surgery, The Second 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