The use of EUS to diagnose malignant portal venous system invasion by pancreatic cancer
- PMID: 8781933
- DOI: 10.1016/s0016-5107(96)70191-8
The use of EUS to diagnose malignant portal venous system invasion by pancreatic cancer
Abstract
Background: CT scanning and mesenteric angiography are insensitive tests diagnosing vascular invasion by pancreatic cancer. Endoscopic ultrasound (EUS) has been proposed as an alternative. The sensitivity, specificity, and accuracy of specific EUS criteria for diagnosing malignant invasion of the branches of the portal venous system have not been determined.
Methods: This is a prospective blinded evaluation of EUS and angiography to diagnose malignant invasion of the portal venous system by pancreatic cancer in 45 patients, 28 of whom underwent surgery. Surgical staging was used as the gold standard for determining the accuracy of EUS and angiography.
Results: Four EUS criteria were studied and the overall accuracy rates were as follows: irregular venous wall (87%), loss of interface (78%), proximity of mass (73%), and size (39%). Although "irregular venous wall" was the most accurate, it suffered from a low sensitivity rate (47%) because of its relative inability to detect superior mesenteric vein invasion (sensitivity of 17%). The angiographic criteria had accuracy rates of 73% to 90% with low sensitivity rates (20% to 77%). The clean resection rate was 86% when all tests were used, 78% if EUS was used without angiography, and 60% if only angiography was used.
Conclusion: EUS is highly sensitive for detecting portal and splenic vein invasion by pancreatic cancer, but may be insensitive for superior mesenteric vein involvement.
Comment in
-
The role of endoscopic ultrasound in the preoperative staging of pancreatic malignancies.Gastrointest Endosc. 1996 Jun;43(6):626-8. doi: 10.1016/s0016-5107(96)70206-7. Gastrointest Endosc. 1996. PMID: 8781948 No abstract available.
Similar articles
-
Pancreatic cancer staging. Endoscopic ultrasonography criteria for vascular invasion.Gastrointest Endosc Clin N Am. 1995 Oct;5(4):741-53. Gastrointest Endosc Clin N Am. 1995. PMID: 8535622
-
Endoscopic ultrasound criteria for vascular invasion in the staging of cancer of the head of the pancreas: a blind reevaluation of videotapes.Gastrointest Endosc. 2000 Oct;52(4):469-77. doi: 10.1067/mge.2000.106682. Gastrointest Endosc. 2000. PMID: 11023562
-
Role of computer tomography and endoscopic ultrasonography in assessing portal and superior mesenteric vessels invasion in cephalo-pancreatic adenocarcinoma.Ann Ital Chir. 2017;88:336-341. Ann Ital Chir. 2017. PMID: 29051395
-
Applications of endoscopic ultrasonography in pancreatic cancer.Cancer Control. 2004 Jan-Feb;11(1):15-22. doi: 10.1177/107327480401100103. Cancer Control. 2004. PMID: 14749619 Review.
-
Role of endoscopic ultrasound in the diagnosis of patients with solid pancreatic masses.Dig Dis. 2004;22(1):26-31. doi: 10.1159/000078732. Dig Dis. 2004. PMID: 15292692 Review.
Cited by
-
Diagnosis of pancreatic tumors by endoscopic ultrasonography.World J Radiol. 2010 Apr 28;2(4):122-34. doi: 10.4329/wjr.v2.i4.122. World J Radiol. 2010. PMID: 21160578 Free PMC article.
-
Pancreatic cancer: can we screen? How should we stage?Curr Gastroenterol Rep. 1999 Apr;1(2):166-74. doi: 10.1007/s11894-996-0017-5. Curr Gastroenterol Rep. 1999. PMID: 10980945 Review.
-
The role of endoscopic ultrasound in biliary strictures.Curr Gastroenterol Rep. 2008 Apr;10(2):157-62. doi: 10.1007/s11894-008-0037-4. Curr Gastroenterol Rep. 2008. PMID: 18462602 Review.
-
The role of endoscopic ultrasound in pancreatic disorders.Int J Pancreatol. 1996 Aug;20(1):1-10. doi: 10.1007/BF02787371. Int J Pancreatol. 1996. PMID: 8872519 Review. No abstract available.
-
Extraintestinal Applications of Endoscopic Ultrasound.Gastroenterol Hepatol (N Y). 2006 Apr;2(4):261-270. Gastroenterol Hepatol (N Y). 2006. PMID: 28286456 Free PMC article.
Publication types
MeSH terms
LinkOut - more resources
Full Text Sources
Medical
