Alessandro Furlan MD, Presenter: Nothing to Disclose

Sonal Krishan MD, Abstract Co-Author: Nothing to Disclose

Kevin McGraft, Abstract Co-Author: Nothing to Disclose

Mitchell E. Tublin MD, Abstract Co-Author: Nothing to Disclose

To compare MDCT and endoscopic ultrasound (EUS) for the prediction of malignancy of cystic pancreatic lesions.

This retrospective, HIPAA-compliant study was approved by the IRB. Between 2005 and 2010, 425 EUS examinations were performed for further characterization of pancreatic lesion detected on MDCT. Inclusion criteria for our study were: i) cystic appearance of the lesion on both MDCT and EUS; ii) imaging available for review. Exclusion criteria were: i) non-contrast MDCT studies; ii) lack of cytologic or histopathologic proof for the lesion. Two radiologists reviewed the MDCT images, and assigned a level of malignancy to the cystic lesion based on combination of morphologic criteria, and using a 5-point scale. A level of malignancy was then assigned to the lesion based on EUS morphologic criteria, using the same scale. Diagnostic ability of MDCT and EUS to predict malignancy was investigated calculating sensitivity and specificity, and compared using receiving operating curve (ROC) curve analysis.

There were 26 patients with 26 cystic pancreatic lesions satisfying the above inclusion criteria; 17/26 (65%) lesions were considered malignant at final pathologic analysis. Sensitivity for prediction of malignancy was 71% (12/17) for MDCT and 88% (15/17) for EUS. Specificity was 44% (4/9) for MDCT and 55% (5/9) for EUS. The area under ROC values showed no statistical difference (0.575 for MDCT, and 0.719 for EUS, P=0.255).

MDCT and EUS are comparable and limited for the prediction of malignancy of cystic pancreatic lesions.

MDCT and EUS have limited ability for the characterization of cystic pancreatic lesions. EUS is a vehicle for definitive characterization via FNA (i.e. cytology, tumor markers).

Furlan, A, Krishan, S, McGraft, K, Tublin, M, Pancreatic Cystic Lesions: Comparison of MDCT and Endoscopic Ultrasound for the Prediction of Malignancy.  Radiological Society of North America 2011 Scientific Assembly and Annual Meeting, November 26 - December 2, 2011 ,Chicago IL. http://archive.rsna.org/2011/11034618.html