Comparison between endoscopic ultrasonography and abdominal CT and MRI for diagnosis of pancreatic cancer

Tarek Mostafa; Ahmed S. Sherbini; Ashraf Metwally; Ibrahim M. Ibrahim; Mohamed I.Radwan; Sameh S. Hegab; Hussein H. Okasha

Volume : VII, Issue : IX, September - 2017

Comparison between endoscopic ultrasonography and abdominal CT and MRI for diagnosis of pancreatic cancer

Tarek Mostafa, Ahmed S. Sherbini, Ashraf Metwally, Ibrahim M. Ibrahim, Mohamed I. Radwan, Sameh S. Hegab, Hussein H. Okasha

Abstract :

Background and aim of the work: Pancreatic cancer is the fourth cause of cancer related death worldwide. Difficult early diagnosis of pancreatic cancer is the main cause of its poor prognosis. Previous studies indicated that CT and MRI equally perform at evaluating resectability of pancreatic cancer. Endoscopic ultrasound (EUS) is a reference method for diagnosing and staging different diseases and through which guided biopsies and fine needle aspirations can be obtained. The aim of this study is to compare EUS, CT and MRI in early diagnosis of pancreatic tumors.

Patients and methods: 48 patients with various pathological types of pancreatic masses were enrolled in this study. They were examined using the three diagnostic modalities and compared to the gold standard which is the cytologic / histopathologic diagnosis of an EUS guided biopsy.

Results: EUS detected 100% of pancreatic tumors even those smaller than 1 cm in diameter. EUS detected nodal metastasis in 65% of cases versus 37.5% in MRI and 7.5% in CT. EUS detected vascular invasion in 50% of cases versus 32.5% in MRI and 7.5% in CT. EUS and MRI detected hepatic metastasis in 20 % of cases versus 7.5% by CT. EUS has sensitivity of 100% and specificity of 75% which are the highest values among the three diagnostic modalities.

Conclusion: Endoscopic ultrasonography is a very sensitive method for detection of pancreatic cancer. EUS is the best diagnostic modality for staging of pancreatic tumors.