European Journal of Radiology
Volume 62, Issue 2 , Pages 166-169, May 2007

The role of CT and endoscopic ultrasound in pre-operative staging of pancreatic cancer

  • Zdenek Kala

      Affiliations

    • Department of Surgery, Faculty Hospital Brno, Jihlavska 20, 639 00 Brno, Czech Republic
    • Tel.: +420 532 232 983.
    • ,
  • Vlastimil Válek

      Affiliations

    • Department of Radiology, Faculty Hospital Brno, Jihlavska 20, 639 00 Brno, Czech Republic
    • Tel.: +420 532 233 007.
    • ,
  • Jan Hlavsa

      Affiliations

    • Department of Surgery, Faculty Hospital Brno, Jihlavska 20, 639 00 Brno, Czech Republic
    • Corresponding Author InformationCorresponding author Tel.: +420 532 232 983; fax: +420 532 233 900.
    • ,
  • Kyselová Hana

      Affiliations

    • Department of Radiology, St. Annás Faculty Hospital, Pekařská 53, 656 91 Brno, Czech Republic
    • Tel.: +420 543 181 111.
    • ,
  • Anna Váňová

      Affiliations

    • Pedagogical Faculty of Masaryk University, Poříčí 9, 603 00, Czech Republic

Received 30 January 2007; accepted 31 January 2007.

Abstract 

Purpose

The aim of our study was to compare the accuracy of computed tomography and endoscopic ultrasound (EUS) in pre-operative staging of pancreatic cancer.

Methods

Comparative retrospective study of 86 patients with pancreatic cancer. CT was done in 55 patients, 41 patients were examined by EUS. Each patient underwent surgery and had proven pancreatic cancer by histology. CT and EUS results were correlated to per-operative and histological findings. The main attention was paid to the description of peri-pancreatic lymphadenopathy, para-aortic lymphadenopathy, peri-coeliac lymphadenopathy and tumor relationship to superior mesenteric vein, superior mesenteric artery, portal vein, inferior caval vein and common hepatic artery. A description rate was defined as number of pre-operative findings where the structures and relationships mentioned above were described.

Results

The description rates of peri-pancreatic lymph nodes were 11 (20%) at CT and 36 (88.0%) at EUS. Para-aortic lymphadenopathy was described in 9 (16.0%) cases at CT and none at EUS. Peri-coeliac lymphadenopathy was mentioned only one time (2.0%) at CT contrary to 12 (29.0%) at EUS. Relationship of the tumor to the mesenteric vessels was well depicted in nine (16.0%) at CT versus nine (22.0%) at EUS. Portal vein relationship was well described in two (4.0%) at CT and seven (17%) cases at EUS. This description rate in vena cava inferior was one (2%) at CT and three (7.0%) at EUS, in hepatic artery it was one (2%) at CT and six (15%) at EUS. In the group of CT, resectability or non-resectability were well predicted in 33 (60%) patients and wrong predicted in 22 (40%) patients. In the group of EUS, resectability or non-resectability were well predicted in 34 (83%) patients and wrong predicted in 7 (17%) patients.

Conclusion

According to our study, EUS is more accurate in prediction of local PC resectability than CT.

Keywords: Pancreatic cancer, CT, Endoscopic ultrasound, Resection

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PII: S0720-048X(07)00061-7

doi:10.1016/j.ejrad.2007.01.039

European Journal of Radiology
Volume 62, Issue 2 , Pages 166-169, May 2007

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