RADIAL SCANNING AND LINEAR-ARRAY ENDOSONOGRAPHY FOR STAGING PANCREATIC-CANCER - A PROSPECTIVE RANDOMIZED COMPARISON

Background: Endoscopic ultrasound (EUS) is known to be accurate for st aging pancreatic cancer. Little data exist to determine if linear arra y or radial scanning EUS is superior for staging pancreatic cancer. Th is prospective comparison was undertaken to assess the accuracy of lin ear array and radial scanning EUS for staging pancreatic cancer. Metho ds: Patients with pancreatic cancer referred for EUS staging were rand omized to linear array or radial scanning EUS. Staging accuracy for ea ch was determined by comparison to surgical pathology in those patient s going to surgery.Results: Seventy-nine patients with pancreatic canc er were enrolled and 33 had surgical resection. Of these, 17 patients were randomized to linear array and 16 to radial scanning EUS. The rem aining 46 patients did not have surgery because of comorbid illness or clinically unresectable disease. EUS staging accuracy for linear arra y was 94% (16 of 17) for T and 71% (12 of 17) for N staging, whereas r adial scanning was 88% (14 of 16) for T and 75% (12 of 16) far N stagi ng. For predicting Vascular invasion, radial scanning was 100% accurat e (16 of 16) while linear array was 94% (16 of 17) accurate. There was one false-negative assessment of invasion using linear array EUS. Con clusion: Overall, both EUS designs appear equivalent for staging pancr eatic cancer and assessing vascular invasion. In view of our findings and the capability for ultrasound-directed fine-needle aspiration with linear array EUS, this instrument may be the preferred choice for eva luating pancreatic masses.