[Prospective comparison of ultrasound endoscopy and computed tomography in the assessment of locoregional invasiveness of malignant ampullar and pancreatic tumors verified surgically]

Abstract

Objective: To compare, in a prospective study, results of endoscopic ultrasonography and computed tomography in staging of pancreatic and ampullary carcinoma tumours, assessed surgically.

Method: From January 1990 to May 1993, 37 patients with pancreatic tumours had per-operative endoscopic ultrasonography and computed tomography. All patients underwent surgery and surgical and histological staging were performed.

Results: All the tumours were visualized by endoscopic ultrasonography, and 92% were correctly localized; 63% of the tumours were visualized by computed tomography. In lymph node involvement diagnosis (23 patients), endoscopic ultrasonography. In major portal vessel involvement diagnosis (14 patients), endoscopic ultrasonography sensitivity and specificity were respectively 71.4% and 95.65%, and 21.4% and 100% for computed tomography. In a vessel-by-vessel analysis, endoscopic ultrasonography was superior to computed tomography for veinous involvement diagnosis (sensitivity: 68.4% vs 26.3%), and the results were similar for arterial involvement diagnosis (sensitivity: 55.5% vs 66.6%).

Conclusion: Endoscopic ultrasonography is more accurate than computed tomography in detection of metastatic lymph nodes and portal involvement, and their results are similar in detection of arterial involvement.