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Comparison of endoscopic ultrasound and computed tomography in the assessment of pancreatic cyst size using pathology as the gold standard

Lookup NU author(s): Professor John LeedsORCiD, Dr Beate Haugk, Professor Kofi Oppong

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Abstract

Background/objectives: Accurate assessment of whether a cyst is greater than 3 cm is an essential component when considering resection especially for mucinous lesions. The most accurate method of assessing cyst size is uncertain with many patients undergoing several complimentary imaging modalities. This study aimed to compare the accuracy of endoscopic ultrasound (EUS) with CT scanning in assessing pancreatic cyst size compared to histology.Methods: Patients referred for EUS of a pancreatic cystic lesion from April 2003 to August 2011. Patient age and gender, lesion size and site were recorded and compared using cyst size at histology compared to EUS and CT recorded within 3 months of surgery. Subgroup analysis was performed with respect to cyst site and proven mucinous lesions.Results: 357 patients were included of which 70 (mean age 60.6 years, 24 males) had undergone surgical resection. The resected cysts were located 30/17/23 in the head/body/tail of the pancreas. Median size at histology was 32 mm compared to 35 mm at EUS (p = 0.47) and 35 mm at CT (p = 0.52). For mucinous lesions alone, median size at histology was 32 mm compared to 33 mm at EUS (p = 0.46) and 35 mm at CT (p = 0.39). EUS and CT had comparable sensitivity, specificity, negative predictive value, positive predictive value and accuracy for all cyst types and locations.Conclusions: CT and EUS measurements are not significantly different to pathological size following resection of pancreatic cystic lesions. CT and EUS are interchangeable investigations for determining cyst size pre-operatively although EUS has the additional advantage of fluid sampling. Copyright (C) 2013, IAP and EPC. Published by Elsevier India, a division of Reed Elsevier India Pvt. Ltd. All rights reserved.

Publication metadata

Author(s): Leeds JS, Nayar MN, Dawwas M, Scott J, Anderson K, Haugk B, Oppong KW

Publication type: Article

Publication status: Published

Journal: Pancreatology

Year: 2013

Volume: 13

Issue: 3

Pages: 263-266

Print publication date: 01/05/2013

Online publication date: 04/03/2013

Acceptance date: 23/02/2013

ISSN (print): 1424-3903

ISSN (electronic): 1424-3911

Publisher: Elsevier BV

URL: http://dx.doi.org/10.1016/j.pan.2013.02.009

DOI: 10.1016/j.pan.2013.02.009

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