According to results recently published in the Annals of Internal Medicine, endoscopic ultrasound appears more accurate in correctly determining the extent of spread of pancreatic cancer than computed tomography (CT). This is important, as the specific stage of pancreatic cancer dictates treatment options.

The stage, or extent of spread, of the pancreatic cancer is important information, as treatment decisions are based on the stage. Therefore, the accuracy of the means in which staging is determined is imperative. The two most common methods of staging pancreatic cancer are CT scans or endoscopic ultrasound (EUS). However, comparative information about these two techniques is limited.

Researchers from Indiana recently conducted a clinical study to compare the accuracy of EUS and CT in patients with suspected pancreatic cancer. This study included 104 patients who were thought to possibly have pancreatic cancer and underwent both EUS and CT (multidetector CT), as well as the surgical removal of the cancer and surrounding tissues or lymph nodes. Laboratory reports from the surgical specimen were used to compare results from both EUS and CT. Eighty of these patients were confirmed as having pancreatic cancer. Overall, EUS detected 98% of pancreatic cancers and CT detected 86% of pancreatic cancers. Among 53 patients who were considered to be eligible to have their cancer surgically removed, EUS correctly staged 67%, while CT correctly staged 47% of these cancers.

The researchers concluded that EUS has a definite role in the staging of pancreatic cancers. Although CT scans may also provide useful information in the staging procedure, EUS should be considered as part of the staging regimen.

Comments: This study clearly documents the added benefit of EUS in staging pancreatic cancer.

Reference: DeWitt J, Devereaux B, Chriswell M, et al. Comparison of endoscopic ultrasonography and multidetector computed tomography for detecting and staging pancreatic cancer. Annals of Internal Medicine. 2004; 141: 753-763.