The team evaluated the ability of endoscopic ultrasound (EUS) alone to predict and differentiate malignant from benign cystic lesions of the pancreas.
The findings of the study were reported in the December issue of the American Journal of Gastroenterology.
Between 1995 and 1999, 98 cases of pancreatic cystic lesions were evaluated by EUS at the authors' institution. All of these cases were originally imaged by cross-sectional modalities that were not diagnostic.
Among these, surgical/pathological correlation was available in 48 patients.
The original endosonographic images were reviewed by two endosonographers who were blinded to each other's interpretation and to the surgical and pathological interpretation.
The EUS images were assessed for the presence or absence of the following characteristics: (1) wall, (2) solid component, (3) septae, (4) lymphadenopathy, and (5) number of cysts.
|No component determined by EUS could predict malignancy.|
| American Journal of Gastroenterology |
These characteristics were then correlated with the surgical and pathological findings and were assessed to determine if any were predictors of the lesion being benign or malignant.
For reviewer A, the presence of a solid component by EUS was the only statistically significant predictor of malignancy (odds ratio = 4.7).
However, the researchers found that 61% of patients with benign lesions were also interpreted by EUS to have a solid component.
For reviewer B, none of the features were found to be significant predictors of a malignant lesion.
When the results of both reviewers were combined, the presence of a solid component was not found to be a statistically significant predictor of malignancy (odds ratio = 1.0).
Author N. A. Ahmad, of the Hospital of the University of Pennsylvania, Philadelphia, concluded on behalf of the group, "Endosonographic features cannot reliably differentiate between benign and malignant cystic lesions of the pancreas after a nondiagnostic cross-sectional modality."