Document Detail


The accuracy of EUS and helical CT in the assessment of vascular invasion by peripapillary malignancy.
MedLine Citation:
PMID:  11174289     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: The relative accuracy of helical CT and EUS for defining the local resectability of peripapillary malignancies is undefined. METHODS: Fifty-one patients with a peripapillary malignancy and no metastatic disease were prospectively evaluated with helical CT and EUS. Imaging results were compared with surgical staging, and a tumor was defined as resectable when there was no macroscopic or microscopic residual tumor. RESULTS: Nine patients had surgically confirmed locally unresectable disease, which was accurately predicted by EUS in 6 patients (sensitivity 67%) and by helical CT in 3 patients (sensitivity 33%; p = 0.35). When only patients with complete EUS examinations were included, the sensitivities of EUS and helical CT for vascular invasion were 100% and 33% (p = 0.06), respectively. When all patients not undergoing surgery because of imaging evidence of locally unresectable disease were included, the sensitivities were 100% and 62.5% (p = 0.02), respectively. One of 15 patients with a tumor amenable to surgical resection was labeled as unresectable by EUS but subsequently had a local recurrence of the tumor. The specificities of EUS (93%) and helical CT (100%) were similar. CONCLUSION: EUS is more sensitive than helical CT for detecting vascular invasion by peripapillary malignancies and should be added to staging protocols, particularly when findings on helical CT are equivocal.
Authors:
W M Tierney; I R Francis; F Eckhauser; G Elta; T T Nostrant; J M Scheiman
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Publication Detail:
Type:  Clinical Trial; Comparative Study; Journal Article    
Journal Detail:
Title:  Gastrointestinal endoscopy     Volume:  53     ISSN:  0016-5107     ISO Abbreviation:  Gastrointest. Endosc.     Publication Date:  2001 Feb 
Date Detail:
Created Date:  2001-02-22     Completed Date:  2001-06-14     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0010505     Medline TA:  Gastrointest Endosc     Country:  United States    
Other Details:
Languages:  eng     Pagination:  182-8     Citation Subset:  IM    
Affiliation:
Department of Medicine, University of Michigan Medical Center, Ann Arbor, Michigan, USA.
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MeSH Terms
Descriptor/Qualifier:
Adenocarcinoma / diagnosis*,  secondary*
Adult
Aged
Aged, 80 and over
Ampulla of Vater*
Common Bile Duct Neoplasms / diagnosis*
Endosonography*
Female
Humans
Male
Middle Aged
Pancreatic Neoplasms / diagnosis*
Predictive Value of Tests
Prospective Studies
Reproducibility of Results
Sensitivity and Specificity
Tomography, X-Ray Computed*
Vascular Neoplasms / diagnosis*,  secondary*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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