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Diagnostic Strategy for Differentiating Autoimmune Pancreatitis From Pancreatic Cancer: Is an Endoscopic Retrograde Pancreatography Essential?
MedLine Citation:
PMID:  22228050     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
OBJECTIVES: The purpose of this study was to determine whether the choice for performance of endoscopic retrograde pancreatography (ERP) could be tailored to findings on computed tomography (CT) in patients with suspected autoimmune pancreatitis (AIP). METHODS: Eighty-four AIP patients and 73 pathology-proven pancreatic cancer patients from a prospectively maintained database were retrospectively included. Computed tomography and ERP images were reviewed in consensus by 2 blinded radiologists. The diagnostic performance of CT alone and combined use of CT and ERP (CT-ERP) were compared. RESULTS: The area under the receiver operating characteristic curve of CT-ERP was significantly greater than that of CT alone (0.97 vs 0.87, P < 0.001). When patients with AIP were divided into 2 subgroups according to CT features (typical vs atypical), 24 (69%) of 35 AIP patients with atypical CT findings were correctly diagnosed with AIP at CT-ERP and received benefits from additional ERP. Endoscopic retrograde pancreatography had little added benefit in patients with typical CT findings for AIP (n = 49), because no alternative diagnoses were established after ERP. CONCLUSIONS: In patients with suspected AIP, the decision to perform ERP could be tailored to findings on CT.
Authors:
Jin Hee Kim; Myung-Hwan Kim; Jae Ho Byun; Seung Soo Lee; So Jung Lee; Seong Ho Park; Sung Koo Lee; Do Hyun Park; Moon-Gyu Lee; Sung-Hoon Moon
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-1-5
Journal Detail:
Title:  Pancreas     Volume:  -     ISSN:  1536-4828     ISO Abbreviation:  -     Publication Date:  2012 Jan 
Date Detail:
Created Date:  2012-1-9     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8608542     Medline TA:  Pancreas     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
From the Departments of *Radiology and Research Institute of Radiology and †Internal Medicine, University of Ulsan College of Medicine, Asan Medical Center, Seoul; and ‡Department of Internal Medicine, Dankook University Hospital, Cheonan, South Korea.
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