Abdominal US for diagnosis of pancreatic tumor: Prospective cohort analysis

PURPOSE: To elucidate the accuracy of abdominal ultrasonography (US) in the diagnosis of pancreatic tumors. MATERIALS AND METHODS: in all patients referred for pancreatic US during 19 88-1990, data on malignant disease and survival were analyzed by using-the Swedish Death and Cancer Registries. Nine hundred nineteen patients were en tered into the analysis. In 140 of them, a clinical diagnosis of tumor in t he pancreatic area was confirmed within 1 year after US. These tumors were primary pancreatic tumors (n = 102), common bile duct and duodenal cancers (n = 17), and metastases in the pancreatic area (n = 21). RESULTS: The sensitivity of US in the detection of all tumors in the pancre atic area was 88.6% (124 of 140 patients), which was similar to that for th e detection of exocrine pancreatic cancer, 90% (79 of 88 patients). There w ere nine false-positive US examinations, for a specificity of 98.8% (770 of 779 patients). Systematic sampling of 94 investigations confirmed an assoc iation between US accuracy and presence of clinical symptoms of pancreatic cancer. Significant differences-in the sensitivity (P <.05) and accuracy (P <.01) of diagnosis were observed between three experienced investigators. CONCLUSION: Study results support the use of US as-a first-line diagnostic examination in patients suspected of having pancreatic tumor. Dependency on the investigator's experience with US mandates continuous evaluation. Of i ts performance.