title: Comparison between CT and CEUS in the diagnosis of pancreatic adenocarcinoma.
abstract: OBJECTIVE
  The aim of this study is to compare CEUS and MDCT features of pancreatic ductal adenocarcinoma in relation to tumor size.
  
  
  METHODS
  All patients with pathological diagnosis of pancreatic adenocarcinoma and studied by means of CEUS and MDCT were enrolled in this study. Two radiologists evaluated tumor size, site and imaging appearance. Patients in which at least one method yielded a positive result were divided into 4 groups on the basis of lesion size. For each dimensional category, sensitivity of the two imaging methods was calculated and compared using McNemar test.
  
  
  RESULTS
  One hundred thirty-three patients were included in this study. In 9 of 133 patients neither MDCT nor US/CEUS could identify the lesion, while in 9 of 133 patients only MDCT and in 13 of 133 only US/CEUS could identify the lesion. In the remaining 102 patients, both MDCT and US/CEUS yielded a positive result. US/CEUS sensitivity was 86.47% while MDCT sensitivity was 83.58%, with no statistically significant difference (p = 0.523). For lesions smaller than 2 cm US/CEUS had a 100% sensitivity, while MDCT had a 73.33% sensitivity with no statistically significant difference (p = 0.125). For lesions between 2.1 and 3 cm US/CEUS had a sensitivity of 95.35%, while MDCT had a sensitivity of 83.72% with no statistically significant difference (p = 0.180). For lesions between 3.1 and 4 cm, US/CEUS had a sensitivity of 87.88%, while MDCT had a sensitivity of 93.94% with no statistically significant difference (p = 0.688). For lesions larger than 4 cm US/CEUS, had a sensitivity of 90.91%, while MDCT had a sensitivity of 100% with no statistically significant difference (p = 0.250).
  
  
  CONCLUSIONS
  US/CEUS sensitivity in diagnosing pancreatic ductal adenocarcinoma is adequate and does not statistically differ from that of MDCT. US/CEUS sensitivity seems to be higher for small and medium lesions, while MDCT sensitivity is higher for large lesions. By combining both the imaging methods a higher accuracy in diagnosing pancreatic ductal adenocarcinoma can be expected.
authors.affiliation: Department of Radiology, University of Verona, Italy. mirko.donofrio@univr.it
authors.forename: M
authors.initials: M
authors.lastname: D'Onofrio
authors.forename: S
authors.initials: S
authors.lastname: Crosara
authors.forename: M
authors.initials: M
authors.lastname: Signorini
authors.forename: R
authors.initials: R
authors.lastname: De Robertis
authors.forename: S
authors.initials: S
authors.lastname: Canestrini
authors.forename: F
authors.initials: F
authors.lastname: Principe
authors.forename: R
authors.initials: R
authors.lastname: Pozzi Mucelli
mesh_terms: D000230:Adenocarcinoma / Q000098:blood supply / Q000175:diagnosis* / Q000378:metabolism; D003287:Contrast Media; D006801:Humans; D007089:Image Enhancement; D061330:Multidetector Computed Tomography; D010179:Pancreas / Q000098:blood supply / Q000473:pathology; D010190:Pancreatic Neoplasms / Q000098:blood supply / Q000175:diagnosis* / Q000473:pathology; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D014463:Ultrasonography
chemical_list: D003287:Contrast Media