Which is the Best Imaging Method in Pancreatic Adenocarcinoma Diagnosis and Staging - CT, MRI or EUS?

INTRODUCTION

Imaging has a decisive role in the diagnosis and staging of pancreatic cancer, the most used imaging methods being computed tomography, magnetic resonance imaging and endoscopic ultrasonography.

MATERIAL AND METHOD

They were studied retrospectively over a 3 years period, 140 patients with pancreatic cancer.

AIM OF THE STUDY

This study aims to determine the effectiveness of CT, MRI and EUS in diagnosis and staging of panceatic cancer.

RESULTS

CT showed a diagnostic accuracy of 83.3%, with sensitivity and specificity of 81.4% and 43% respectively. MRI showed superior diagnostic accuracy compared to CT (89,1%). However, EUS demonstrated the best diagnostic value in PC (accuracy of 92,7%). Concerning the locoregional staging, the 3 diagnostic methods showed similar result. There were no significant differences concerning the diagnosis of intra-abdominal metastases. Differences have appeared in the case of extra-abdominal. Thus, there were 4 cases of lung metastases which have been identified only on CT and MRI.

CONCLUSION

EUS is the most effective technique used in the diagnosis of pancreatic cancer, the present study demonstrating an accuracy of 92.7%. Moreover, EUS offers the possibility to collect samples for cytological examination by EUS guided fine needle aspiration. However, there are some limitations of EUS in identifying extra-abdominal metastases. Thus, the assessment of tumor extension must be completing by performing CT or MRI.