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Comparison between endoscopic ultrasound and magnetic resonance imaging for the staging of pancreatic cancer.
MedLine Citation:
PMID:  21499211     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
OBJECTIVE: : Preoperative staging of pancreatic cancer is crucial for proper therapy. Through this study, we aimed to compare the ability of endoscopic ultrasound (EUS) and magnetic resonance imaging (MRI) to effectively detect and stage pancreatic cancer.
METHODS: : One hundred twenty-seven patients undergoing EUS-fine-needle aspiration and MRI for the workup of pancreatic cancer were captured in a prospective database for comparison. The final surgical stage was recorded in patients who went to surgery.
RESULTS: : Of 127 patients, 48 were surgically explored, and of these, 22 (46%) underwent pancreaticoduodenectomy. Agreement in the patients' staging between EUS and MRI was 94 (74%) of 127. Magnetic resonance imaging was more likely to report metastatic disease or arterial involvement. The overall correlation between EUS and MRI was marginal (κ = 0.42; 95% CI, 0.26-0.58). Of the 48 surgically explored patients, 12 (25%) were understaged by MRI, 13 (27%) were understaged by EUS, and 1 (2%) were overstaged. Endoscopic US and MRI had a sensitivity of 34 (97.2%) of 35 for stage II tumors and 35 (100%) of 35 for lower-stage tumors, respectively.
CONCLUSION: : Endoscopic US and MRI had marginal correlation for staging, especially the more advanced tumors. Although EUS has the added advantage of tissue acquisition for confirmation, the tumors understaged by both the modalities were different. Therefore, both tests should be performed for accurate staging.
Authors:
Vanessa M Shami; Anshu Mahajan; Michelle M Loch; Alejandro C Stella; Patrick G Northup; Grace E White; Andrew S Brock; Indu Srinivasan; Eduard E de Lange; Michel Kahaleh
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Pancreas     Volume:  40     ISSN:  1536-4828     ISO Abbreviation:  Pancreas     Publication Date:  2011 May 
Date Detail:
Created Date:  2011-04-18     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8608542     Medline TA:  Pancreas     Country:  United States    
Other Details:
Languages:  eng     Pagination:  567-70     Citation Subset:  IM    
Affiliation:
From the Digestive Health Center, University of Virginia Health System, Charlottesville, VA.
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