Sensitivity of CT, MRI, and EUS-FNA/B in the preoperative workup of histologically proven left-sided pancreatic lesions

Left-sided pancreatic lesions are often treated surgically. Accurate diagnostic work-up is therefore essential to prevent futile major abdominal surgery. Large series focusing specifically on the preoperative work-up of left-sided pancreatic lesions are lacking. This surgical cohort analysis describ...

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Vydané v:Pancreatology : official journal of the International Association of Pancreatology (IAP) ... [et al.] Ročník 22; číslo 1; s. 136 - 141
Hlavní autori: Gorris, Myrte, Janssen, Quisette P., Besselink, Marc G., van den Broek, Bram L.J., van Eijck, Casper H.J., van Gils, Marjon J., Koerkamp, Bas Groot, Struik, Femke, van Driel, Lydi M.J.W., van Hooft, Jeanin E.
Médium: Journal Article
Jazyk:English
Vydavateľské údaje: Switzerland Elsevier B.V 01.01.2022
Elsevier Limited
Predmet:
Abdomen
Abdominal surgery
Aged
Computed tomography
Computed tomography (CT)
Cysts
Diagnosis
Endoscopic ultrasonography
Endoscopic Ultrasound-Guided Fine Needle Aspiration
Endoscopy
Endosonography
Female
Humans
Lesions
Magnetic Resonance Imaging
Magnetic resonance imaging (MRI)
Male
Middle Aged
Pancreas
Pancreatic Cyst - diagnostic imaging
Pancreatic lesions
Pancreatic Neoplasms - diagnostic imaging
Pancreatic Neoplasms - surgery
Pancreatitis
Patients
Preoperative Care
Sensitivity
Sensitivity and Specificity
Surgery
Tomography, X-Ray Computed
Tumors
Magnetic resonance imaging (MRI)
Sensitivity
Computed tomography (CT)
Pancreatic lesions
Endoscopic ultrasonography
ISSN:1424-3903, 1424-3911, 1424-3911
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Shrnutí:Left-sided pancreatic lesions are often treated surgically. Accurate diagnostic work-up is therefore essential to prevent futile major abdominal surgery. Large series focusing specifically on the preoperative work-up of left-sided pancreatic lesions are lacking. This surgical cohort analysis describes the sensitivity of CT, MRI, and EUS-FNA/B in the diagnostic work-up of left-sided pancreatic lesions. We performed a post-hoc analysis of patients who underwent surgery for a left-sided pancreatic lesion between April 2010 and August 2017 and participated in the randomized CPR trial. Primary outcome was the sensitivity of CT, MRI, and EUS-FNA/B. Sensitivity was determined as the most likely diagnosis of each modality compared with the postoperative histopathological diagnosis. Additionally, the change in sensitivity of EUS versus EUS-FNA/B (i.e., cyst fluid analysis, and/or tissue acquisition) was measured. Overall, 181 patients were included (benign: 23%, premalignant: 27%, malignant: 50%). Most patients had solid lesions (65%). Preoperative imaging included CT (86%), MRI (41%), EUS (68%). Overall, CT and EUS-FNA/B reached a sensitivity of both 71%, compared with 66% for MRI. When EUS was combined with FNA/B, sensitivity rose from 64% to 71%. For solid lesions, CT reached the highest sensitivity (75%) when compared with MRI (70%) and EUS-FNA/B (69%). For cystic lesions, EUS-FNA/B reached the highest sensitivity (75%) when compared with CT and MRI (both 62%). CT is the most sensitive diagnostic modality for solid and EUS-FNA/B for cystic left-sided pancreatic lesions. EUS-FNA/B was associated with an increased sensitivity when compared to EUS alone.
Bibliografia:ObjectType-Article-1
SourceType-Scholarly Journals-1
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ISSN:1424-3903
1424-3911
1424-3911
DOI:10.1016/j.pan.2021.11.008