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CC BY-NC-ND 4.0 · Indian J Radiol Imaging 2020; 30(03): 294-303
DOI: 10.4103/ijri.IJRI_437_19
GIT Imaging

Comparative analysis and assessment of diagnostic accuracy of 256 slice CT and endoscopic ultrasound in evaluation of pancreatic masses

Surabhi Gupta
Department of Radiology, G.B. Pant Institute of Postgraduate Medical Education and Research, Jawahar Lal Nehru Marg, New Delhi, India
,
Sunil K Puri
Department of Radiology, G.B. Pant Institute of Postgraduate Medical Education and Research, Jawahar Lal Nehru Marg, New Delhi, India
› Author Affiliations Financial support and sponsorship Funded by Government of Delhi.
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Abstract

Context: Pancreatic masses are routinely encountered on imaging and often present as a diagnostic dilemma. These masses range from benign inflammatory masses, requiring no intervention to malignant masses, which carry grave prognosis and hence require aggressive management. Aims: Compare the diagnostic accuracy of 256 multislice CT and endoscopic ultrasound (EUS) in characterization and assessment of resectability of pancreatic masses and compare the multidetector computed tomography (MDCT) and EUS findings with histopathological findings. Settings and Design: Prospective study. Subjects and Methods: 36 patients with pancreatic masses were included who underwent dual phase CT using pancreatic protocol and EUS using 5–13 MHz transducer. Fine needle aspiration cytology (FNAC) was done wherever feasible. Parameters regarding tumor size, location, imaging morphology, and vessel involvement were recorded. Findings were compared with histopathological/operative diagnosis/clinical follow-up. Statistical Analysis Used: Descriptive statistics with percentages and proportions and Chi-square test. Results: Multidetector computed tomography (MDCT) and EUS established diagnosis consistent with tissue diagnosis in 30 (83%) and 22 (61%) patients, respectively. However, the best results were obtained with the combined use of MDCT and EUS. The number of patients categorized as inconclusive by MDCT were lower compared to EUS. Assessing resectability for pancreatic adenocarcinoma, MDCT showed specificity and positive predictive value (PPV) of 100% compared to EUS, which had specificity and PPV of 75% and 92.3%, respectively. MDCT is the first-line imaging modality in detection, characterization of pancreatic masses, and assessment of resectability in malignant neoplasms. EUS is beneficial in the detection of masses <2 cm in size causing pancreatic contour deformity on CT, for guiding FNAC. MDCT and EUS with EUS-guided FNA are complementary not competitive tools in preoperative imaging of pancreatic masses.

Keywords

Endoscopic ultrasound - multidetector CT - pancreas


Publication History

Received: 24 December 2019

Accepted: 03 June 2020

Article published online:
19 July 2021

© 2020. Indian Radiological Association. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).

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