[Prospective comparison of ultrasonography, helical computed tomography, magnetic resonance imaging, and endoscopic ultrasonography in assessing locoregional invasion of primary pancreatic carcinoma].
OBJECTIVE
To evaluate prospectively the efficacy and clinical significance of ultrasonography (US), helical computed tomography (HCT), endoscopic ultrasonography (EUS) and magnetic resonance imaging (MRI) in assessing locoregional invasion to the surrounding tissue or organs of primary pancreatic carcinoma.


METHODS
Sixty-eight consecutive patients with pancreatic carcinoma underwent US, HCT, EUS and MRI examinations before surgical exploration. All imaging results in terms of tumor size and locoregional invasion were assessed separately by two diagnostic radiologists and compared with the surgical and pathological findings.


RESULTS
Among the HCT, US, EUS and MRI examinations, EUS had the highest accuracy in assessing tumor size with a regression coefficient for the maximal and minimal diameter of 1.0250 (P = 0.0426) and 0.9873 (P < 0.0001), respectively. In the assessment of locoregional invasion to the surrounding tissue or organs, EUS also had the highest accuracy (75.8%) and sensitivity (80.0%), but MRI had the highest positive predicting value (97.4%). None of these four imaging techniques was significantly correlated with the surgical findings when analyzed by univariate logistic regression.


CONCLUSIONS
Endoscopic ultrasonography may be the most useful imaging technique in assessing tumor size, but for assessing loco-regional invasion of primary pancreatic carcinoma, combination of more than one imaging techniques may be necessary.
Tian
Yan-Tao
YT
Department of Abdominal Surgical Oncology, Cancer Hospital (Institute), Chinese Academy of Medical Sciences, Beijing 100021, China.
Wang
Cheng-Feng
CF
Zhao
Xin-Ming
XM
Wang
Gui-Qi
GQ
Ou
Yang-Han
YH
Hao
Yu-Zhi
YZ
Chen
Yan
Y
Zhang
Hong-Mei
HM
Zhao
Ping
P
D000328:Adult; D000368:Aged; D003952:Diagnostic Imaging / Q000379:methods*; D019160:Endosonography; D005260:Female; D006801:Humans; D016015:Logistic Models; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness / Q000473:pathology*; D010190:Pancreatic Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery; D011446:Prospective Studies; D011877:Radionuclide Imaging; D036542:Tomography, Spiral Computed; D047368:Tumor Burden