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Lai JP, Yue Y, Zhang W, et al. Comparison of endoscopic ultrasound guided fine needle aspiration and PET/CT in preoperative diagnosis of pancreatic adenocarcinoma. Pancreatology. 2017;17(4):617-622doi: 10.1016/j.pan.2017.04.008.
Lai, J. P., Yue, Y., Zhang, W., Zhou, Y., Frishberg, D., Jamil, L. H., Mirocha, J. M., Guindi, M., Balzer, B., Bose, S., Cao, D., Lo, S., Fan, X., & Rutgers, J. K. (2017). Comparison of endoscopic ultrasound guided fine needle aspiration and PET/CT in preoperative diagnosis of pancreatic adenocarcinoma. Pancreatology : official journal of the International Association of Pancreatology (IAP) ... [et al.], 17(4), 617-622. https://doi.org/10.1016/j.pan.2017.04.008
Lai, Jin-Ping, et al. "Comparison of endoscopic ultrasound guided fine needle aspiration and PET/CT in preoperative diagnosis of pancreatic adenocarcinoma." Pancreatology : official journal of the International Association of Pancreatology (IAP) ... [et al.] vol. 17,4 (2017): 617-622. doi: https://doi.org/10.1016/j.pan.2017.04.008
Lai JP, Yue Y, Zhang W, Zhou Y, Frishberg D, Jamil LH, Mirocha JM, Guindi M, Balzer B, Bose S, Cao D, Lo S, Fan X, Rutgers JK. Comparison of endoscopic ultrasound guided fine needle aspiration and PET/CT in preoperative diagnosis of pancreatic adenocarcinoma. Pancreatology. 2017 Jul - Aug;17(4):617-622. doi: 10.1016/j.pan.2017.04.008. Epub 2017 Apr 13. PMID: 28501471.
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Pancreatology. 2017 Jul - Aug;17(4):617-622. doi: 10.1016/j.pan.2017.04.008. Epub 2017 Apr 13.

Comparison of endoscopic ultrasound guided fine needle aspiration and PET/CT in preoperative diagnosis of pancreatic adenocarcinoma.

Pancreatology : official journal of the International Association of Pancreatology (IAP) ... [et al.]

Jin-Ping Lai, Yong Yue, Wei Zhang, Yihua Zhou, David Frishberg, Laith H Jamil, James M Mirocha, Maha Guindi, Bonnie Balzer, Shikha Bose, Dengfeng Cao, Simon Lo, Xuemo Fan, Joanne K Rutgers

Affiliations

  1. Department of Pathology and Laboratory Medicine, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA; Department of Pathology, Saint Louis University School of Medicine, St. Louis, MO 63104, USA. Electronic address: [email protected].
  2. Department of Radiation Oncology, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA.
  3. Department of Internal Medicine, Saint Louis University School of Medicine, St. Louis, MO 63104, USA.
  4. Department of Radiology, Saint Louis University School of Medicine, St. Louis, MO 63104, USA.
  5. Department of Pathology and Laboratory Medicine, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA.
  6. Division of Gastroenterology and Hepatology, Digestive Disease Center, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA.
  7. Biostatistics Core, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA.
  8. Department of Pathology, Immunology and Laboratory Medicine, Washington University in St. Louis, St. Louis, MO 63130, USA.
  9. Department of Pathology and Laboratory Medicine, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA. Electronic address: [email protected].

PMID: 28501471 DOI: 10.1016/j.pan.2017.04.008

Abstract

BACKGROUND: Endoscopic ultrasound guided fine needle aspiration (EUS-FNA) is the procedure of choice to investigate and sample pancreatic masses for the preoperative diagnosis of pancreatic ductal adenocarcinoma (PDAC). The role of

METHODS: Preoperative evaluation by PET/CT and EUS-FNA was performed on 25 patients with pancreatic solid lesions, who underwent a subsequent Whipple procedure or partial pancreatic resection.

RESULTS: This series included 19 PDACs and 6 non-PDACs including 1 metastatic breast ductal adenocarcinoma, 2 low grade neuroendocrine tumors, 2 chronic pancreatitis and 1 gastrointestinal tumor abutting the pancreas. EUS-FNA correctly diagnosed 18 of 19 PDACs, 1 metastatic breast ductal adenocarcinoma and all 5 of the other non-PDAC cases. One case of well differentiated PDAC was negative on EUS-FNA. PET/CT provided excellent size and was positive in 14 of 19 PDACs and the metastatic breast ductal adenocarcinoma. The sensitivity, specificity, positive predictive value, negative predictive value and accuracy for EUS-FNA in diagnosis of selected pancreatic tumors were 91%, 100%, 100%, 50% and 92%, respectively, while they were 65%, 100%, 100%, 20% and 68% for PET/CT, respectively.

CONCLUSIONS: Compared to PET/CT, EUS-FNA has a higher sensitivity and accuracy for preoperative diagnosis of PDAC. However, PET/CT provides excellent size, volume and stage information. A combination of both PET/CT and EUS will better help guide diagnosis and treatment of pancreatic adenocarcinoma.

Copyright © 2017. Published by Elsevier B.V.

Keywords: EUS-FNA; PET/CT; Pancreatic cancer

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