Multi-detector Computed Tomography versus Endoscopic Ultrasonography for the Detection of Pancreatic Cancer
Pradermchai Kongkam MD1, Veeravich Jaruvongvanich MD1, Khin Ave MD2, Satimai Aniwan MD1, Surachai Amornsawadwattana MD1, Akira Aso MD1, Shuji Shimizu MD, PhD1, Pinit Kullavanijaya MB, ChB1, Rungsun Rerknimitr MD1
Affiliation : * Pancreas Research Unit, Gastrointestinal Endoscopy Excellence Center, Department of Medicine, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, Thailand ** Department of Endoscopic Diagnostics and Therapeutics, Kyushu University Hospital, Fukuoka, Japan
Objective : Endoscopic ultrasonography [EUS] has been claimed to be superior to computed tomography in detecting
pancreatic cancer. However, there have been only few studies comparing multi-detector computed tomography [MDCT]
with EUS. This study aims to compare the detection rate of EUS with that of MDCT for pancreatic cancer.
Materials and Methods: This retrospective study took place in January 2009 to January 2014 at King Chulalongkorn
Memorial Hospital, Bangkok, Thailand. Patients who underwent both EUS and MDCT for suspected or known pancreatic
cancer were included. Patients with insufficient data, cystic pancreatic lesion, benign masses and/or other malignant masses
were excluded. Only patients with pathologically proven pancreatic ductal adenocarcinoma were included for analysis. The
detection rates of EUS and MDCT for pancreatic cancer were compared.
Results : Sixty-eight patients with pathologically proven pancreatic adenocarcinoma (mean age 63.2+10.9 years) were
analyzed. The mean maximal diameters of lesions identified (n = 60) and missed (n = 8) by MDCT were 43.7+15.6 mm and
18.4+2.9 mm, respectively. EUS and MDCT detection rate for pancreatic cancer was 98.5% and 88.2%, respectively. In
pancreatic tumors 2 cm in diameter, EUS and MDCT detection rate was 83.3% and 0%, respectively. The pancreatic tumors
that were missed by EUS were associated with baseline calcified chronic pancreatitis.
Conclusion : EUS had a higher detection rate than MDCT for detection of pancreatic cancer, particularly for small pancreatic
tumors. However, it missed pancreatic tumor in a patient with calcified chronic pancreatitis.
Keywords : Endoscopic ultrasonography, Endoscopic ultrasound, Endosonography, EUS, Pancreatic cancer, Pancreatic neoplasm, Solid pancreatic lesion,
