COMPARISON BETWEEN EUS AND CROSS-SECTIONAL IMAGING FOR THE ESTIMATION OF PANCREATIC CYSTS SIZE: A SINGLE CENTER EXPERIENCE

Aims The widespread use and advances in diagnostic imaging results to an increase in the incidental finding of pancreatic cysts. According to the published guidelines, the size of the cyst is a risk factor for the surveillance and management. The aim of the study was to compare the size of a pancreatic cyst measured by a cross-sectional imaging (CT/MRI) and the endoscopic ultrasonography (EUS).

Methods All the patients with a pancreatic cyst found in a cross sectional imaging refered to the Endoscopy Unit for EUS between 2018-2019, were included in this retrospective study. The size of the cyst in the CT/MRI report was compared with the size measured by the EUS (PENTAX linear EUS, Hitachi unit) performed by a single operator (DT).

Results Seventy-one patients (F: 45, M: 36) with a mean age of 62,2 years (59,2-65,2) underwent EUS. The mean diameter of the pancreatic cysts was 22,2 mm (range: 19,7-24,7 mm) and 19,5 (range: 17,4-21,6 mm) measured by CT/MRI and EUS, respectively with a significant difference between the two methods (p< 0,001). A linear correlation of the measured size with the two methods was found (Δ_EUS=0,77*Δ_CT/MRI, p< 0,001). In the secondary analysis of the results we found that the size of the cysts with a dilated pancreatic duct was significantly greater (p=0,44), as well as the size of the cysts with a mural nodule, but without a significant difference (p=0,065).

Conclusions In the small number of the patients examined, a difference in the measured size of the pancreatic cysts by ta cross-sectional imaging and the EUS was found. It seems that the EUS underestimates the size of the cysts and particularly the size of the greater ones.