title: Preoperative Diagnosis of Pancreatic Cystic Lesions: The Accuracy of Endoscopic Ultrasound and Cross-Sectional Imaging.
abstract: OBJECTIVE
  This study aimed to evaluate the accuracy of endoscopic ultrasound (EUS) and cross-sectional imaging including multidetector computed tomography (MDCT) or magnetic resonance imaging (MRI) as a preoperative diagnostic modality for the pancreatic cystic lesions.
  
  
  METHODS
  Three hundred eighteen patients with surgically proven pancreatic cystic lesions were enrolled as a study cohort from 1998 to 2011. Preoperative radiological, EUS, and final histopathologic diagnosis were correlated to measure several kinds of diagnostic performance.
  
  
  RESULTS
  A total of 318 patients underwent preoperative MDCT, with additional imaging modalities such MRI and/or EUS in 215 (67.6%) and 108 (34.0%) patients, respectively. κ Values among the different modalities were as follows: MDCT versus pathology = 0.52 (P < 0.0001), MDCT + MRI versus pathology = 0.674 (P < 0.0001), and EUS versus pathology = 0.558 (P < 0.0001). The sensitivity and specificity in terms of ability to predict neoplastic cysts were as follows: MDCT, 83.1%/70.0%; MDCT + MRI, 94.7%/58.7%; and EUS, 88.5%/52.9%. The diagnostic accuracies of MDCT and MDCT + MRI were 61.4% (62/101) and 80.5% (173/215), respectively, and that of EUS was 70.4% (76/108).
  
  
  CONCLUSIONS
  Magnetic resonance imaging as an additional diagnostic modality to MDCT increased the accuracy, sensitivity, and specificity, as well in terms of predicting neoplastic cysts.
authors.affiliation: From the *Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine, Seoul; †Department of Internal Medicine, Seonam University Myongji Hospital, Goyang-si, Gyeonggi-do; and ‡Department of Radiology, Seoul National University College of Medicine, Seoul, Korea.
authors.forename: Dong Kee
authors.initials: DK
authors.lastname: Jang
authors.forename: Byeong Jun
authors.initials: BJ
authors.lastname: Song
authors.forename: Ji Kon
authors.initials: JK
authors.lastname: Ryu
authors.forename: Kwang Hyun
authors.initials: KH
authors.lastname: Chung
authors.forename: Ban Seok
authors.initials: BS
authors.lastname: Lee
authors.forename: Joo Kyung
authors.initials: JK
authors.lastname: Park
authors.forename: Sang Hyub
authors.initials: SH
authors.lastname: Lee
authors.forename: Yong-Tae
authors.initials: YT
authors.lastname: Kim
authors.forename: Jae Young
authors.initials: JY
authors.lastname: Lee
mesh_terms: D000328:Adult; D000368:Aged; D015331:Cohort Studies; D019160:Endosonography / Q000379:methods*; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D061330:Multidetector Computed Tomography / Q000379:methods*; D010181:Pancreatic Cyst / Q000175:diagnosis*; D057234:Preoperative Period; D011379:Prognosis; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D055815:Young Adult