Endoscopy 2018; 50(04): S60
DOI: 10.1055/s-0038-1637204
ESGE Days 2018 oral presentations
20.04.2018 – EUS: diagnostic
Georg Thieme Verlag KG Stuttgart · New York

CONTRAST-ENHANCED ENDOSCOPIC ULTRASOUND VERSUS MULTIDETECTOR COMPUTED TOMOGRAPHY TO DIFFERENTIATE PANCREATIC CANCER FROM CHRONIC PANCREATITIS

F Harmsen
1   St. Elisabeth Hospital Leipzig, Department of Internal Medicine II, Leipzig, Germany
2   University of Muenster, Department of Medicine B, Muenster, Germany
,
D Domagk
3   Josephs-Hospital Warendorf,Academic Teaching Hospital, University of Muenster, Department of Medicine I, Warendorf, Germany
,
CF Dietrich
4   Caritas-Krankenhaus Bad Mergentheim, Medical Clinic 2, Bad Mergentheim, Germany
,
M Hocke
5   Helios Klinikum Meiningen, Department of Internal Medicine II, Meiningen, Germany
› Author Affiliations
Further Information

Publication History

Publication Date:
27 March 2018 (online)

 

Aims:

To compare multidetector computed tomography and contrast-enhanced endoscopic ultrasound in their capacity to differentiate chronic pancreatitis from pancreatic carcinoma.

Methods:

Two hundred and fifteen patients (62 ± 15yrs, 135 males) were included in this study. B-mode endoscopic ultrasound (EUS) and contrast-enhanced high mechanical index ultrasound (CEHMI-EUS) were performed in all patients. Contrast-enhanced low mechanical index ultrasound (CELMI-EUS) was performed in 159 patients, endoscopic sonoelastography (ESE) in 210 patients and multidetector computed tomography in 131 patients. Final diagnosis was achieved by cytological specimen, operation or follow-up greater than one year. Head-to-head analysis was possible in a subgroup of 100 patients in which all five modalities were performed.

Results:

Sensitivity and specificity of MDCT for pancreatic carcinoma were 89% and 70% respectively. Sensitivites and specificities for EUS were 92% and 63% for B-mode EUS, 96% and 38% for ESE, 82% and 76% for CELMI-EUS, 96% and 91% for CEHMI-EUS respectively. In the head-to-head analysis, each modality showed lower numbers for specificity than overall group analysis because of high drop-out rates.

Conclusions:

Contrast-enhanced endoscopic ultrasound promises to be a reliable tool in differentiating pancreatic carcinoma from chronic pancreatitis and should be considered a standard procedure when pancreatic carcinoma is suspected and as follow-up tool in patients with chronic pancreatitis.