[Prospective evaluation of ultrasonography, multi-slice spiral CT, endoscopic ultrasonography, and magnetic resonance imaging in assessment of TNM staging and assessment of resectability in pancreatic carcinoma].
OBJECTIVE
To evaluate prospectively the efficacy and clinical significance of ultrasonography (US), multi-slice spiral CT (MSCT), magnetic resonance imaging (MRI), and endoscopic ultrasonography (EUS) in assessment of the TNM staging and resectability of pancreatic carcinoma.


METHODS
Consecutive 68 patients with pancreatic carcinoma underwent US, MSCT, MRI, and EUS to assess their efficacies in assessment of the size of carcinoma, lymph node metastasis, and distant metastasis. The results of theses imaging techniques were compared with the surgical and pathological findings.


RESULTS
EUS was the most precise technique in evaluating the T staging of pancreatic carcinoma with the coefficients of regression of maximum and minimum radii of 1.025 (P=0.043) and 0.987 (P<0.0001). In the assessment of lymph node metastasis, EUS had the highest sensitivity (75.0%), accuracy (87.5%), and negative predictive values (91.7%). Univariate logistic regression showed that EUS was significantly correlated with the surgical findings (OR: 33.00, 95%CI: 7.18-151.77 P<0.0001). Multivariate logistic regression analysis confirmed that EUS had an independent predictive value (OR: 34.50, 95%CI: 6.54-182.09, P<0.0001). MSCT had the highest sensibility (88.9%) in the assessment of distant metastasis and had the highest accuracy (61.8%) in preoperative TNM staging of pancreatic carcinoma. All 4 imaging techniques were correlated with surgical findings in assessment of the resectability. Multivariate logistic regression analysis confirmed that none of the imaging techniques had independent predictive value.


CONCLUSIONS
MSCT is the best method in preoperative TNM staging of pancreatic carcinoma. EUS is the best methods in the assessment of tumor size and lymph node metastasis. Preoperative assessment of pancreatic carcinoma needs combination of at least two kinds of imaging techniques.
Tian
Yan-tao
YT
Department of Abdominal Surgical Oncology, Cancer Hospital, Chinese Academy of Medical Sciences, Beijing 100021, China.
Wang
Cheng-feng
CF
Shan
Yi
Y
Zhao
Dong-bing
DB
Wang
Gui-qi
GQ
Zhao
Xin-ming
XM
Ouyang
Han
H
Hao
Yu-zhi
YZ
Sun
Yue-min
YM
Qu
Hui
H
Zhao
Ping
P
D003952:Diagnostic Imaging / Q000379:methods*; D019160:Endosonography; D006801:Humans; D008279:Magnetic Resonance Imaging; D009362:Neoplasm Metastasis; D009367:Neoplasm Staging; D010190:Pancreatic Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology*; D036542:Tomography, Spiral Computed; D014057:Tomography, X-Ray Computed