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DOI: 10.1055/s-0038-1637204
CONTRAST-ENHANCED ENDOSCOPIC ULTRASOUND VERSUS MULTIDETECTOR COMPUTED TOMOGRAPHY TO DIFFERENTIATE PANCREATIC CANCER FROM CHRONIC PANCREATITIS
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.