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 25 May 2018

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Endoscopic ultrasonography vs multidetector CT

Compared with multidetector CT, endoscopic ultrasonography is superior for tumor detection and staging but similar for nodal staging and resectability of preoperatively suspected nonmetastatic pancreatic cancer, finds a study in the most recent issue of Annals of Internal Medicine.

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Accurate preoperative detection and staging of pancreatic cancer may identify patients with locoregional disease that is amenable to surgical resection.

Dr De Witt and colleagues from America undertook a study to compare endoscopic ultrasonography and multidetector computed tomography (CT) for the detection, staging, and resectability of known or suspected locoregional pancreatic cancer.

In this prospective, observational, cohort study, the researchers recruited 120 particpants with known or suspected locoregional pancreatic cancer from a single, tertiary referral hospital in Indianapolis, Indiana.

The researchers performed endoscopic ultrasonography followed by multidetector CT in all patients.

The investigators also considered patients with known or suspected pancreatic cancer deemed potentially resectable by 1 or both tests for surgery.

The research team considered surgically resected pancreatic cancer with negative microscopic histologic margins as resectable.

Endoscopic ultrasonography and CT correctly identified 88% and 92%, respectively, as resectable out of the 25 resectable pancreatic tumors
Annals of Internal Medicine

Of 120 patients enrolled, 104 (87%) underwent endoscopic ultrasonography and CT.

The researchers found that out of the 80 patients with pancreatic cancer, 34% were managed nonoperatively, and 66% treated surgically had resectable (n = 25) or unresectable (n = 28) cancer.

In addition, the researchers noted that for the 80 patients with cancer, the sensitivity of endoscopic ultrasonography for detecting a pancreatic mass was greater than that of CT.

Endoscopic ultrasonography was superior to CT for tumor staging accuracy but equivalent for nodal staging accuracy for the 53 surgical patients.

The researchers found that endoscopic ultrasonography and CT correctly identified 88% and 92%, respectively, as resectable out of the 25 resectable pancreatic tumors in patients recommended for surgery.

In addition, of the 28 unresectable pancreatic tumors in patients recommended for surgery, endoscopic ultrasonography and CT correctly identified 68% and 64%, respectively, as unresectable.

Radiologists who read the scans and endosonographers were not blinded to previous radiographic information.

Dr DeWitt concluded, "Compared with multidetector CT, endoscopic ultrasonography is superior for tumor detection and staging but similar for nodal staging and resectability of preoperatively suspected nonmetastatic pancreatic cancer."

Annals of Internal Medicine; 2004: 141 (10): 753-763
17 November 2004

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