The diagnostic accuracy of endoscopic ultrasound vs. contrast-enhanced computed tomography in local staging of pancreatic adenocarcinoma: A bi-national multicenter study

Wisam Sbeit, Mahmoud Salman, Abed Khalaileh, Ahmad Zoabi, Zakhar Bramnik, David Hovel, Mahmud Mahamid, Eran Israeli, Lior Katz, Reem Khoury, Nama Mubariki, Andrea Lisotti, Halim Awadie, Tawfik Khoury*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

Abstract

Background Identification of pancreatic cancer (PC) local invasion is crucial to optimize patients' selection for surgery. Aims To determine the diagnostic accuracy of contrast-enhanced computed tomography (CECT) and endoscopic ultrasound (EUS) in local staging of PC. Methods We performed a multicenter study including all patients with PC who underwent surgery. Results One hundred twelve patients were included. Surgical findings of peri-pancreatic lymph nodes (LN), vascular and adjacent organ involvement were seen in 67 (59.8%), 33 (29.5%) and 19 patients (17%), respectively. The diagnostic performance of EUS was better than CECT in peri-pancreatic LN. The sensitivity, specificity, positive predictive value (PPV) and negative predictive (NPV) of CECT vs. EUS were 28.4%, 80%, 67.9% and 42.9% vs. 70.2%, 75.6%, 81% and 63%, respectively. For vascular and adjacent organ involvement, the sensitivity, specificity, PPV and NPV were 45.5%, 93.7%, 75%, 80.4% and 31.6%, 89.2%, 37.5% and 86.5% for CECT, respectively, vs. 63.6%, 93.7%, 80.8%, 86.1% and 36.8%, 94.6%, 58.3% and 88% for EUS, respectively. Combining both CECT and EUS, the sensitivity for peri-pancreatic LN, vascular and adjacent organ involvement improved (76.1%, 78.8% and 42%), respectively. Conclusion EUS was superior to CECT in local staging. Combined EUS and CECT had a higher sensitivity than either alone.

Original languageEnglish
Pages (from-to)974-979
Number of pages6
JournalEuropean Journal of Gastroenterology and Hepatology
Volume35
Issue number9
DOIs
StatePublished - 1 Sep 2023
Externally publishedYes

Keywords

  • CT
  • adenocarcinoma
  • endoscopic ultrasound
  • pancreas
  • yield

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