Comparison between triphasic CT and EUS pancreatic biopsy in characterization of pancreatic lesions

Abstract

Background: In the detection of pancreatic lesions, diagnostic imaging aims to expand therapeutic options from palliative to curable. Diagnostic imaging techniques have been developed to elevate the ability to diagnose pancreatic cancer. To have the best possible outcome for the patient and avoid wasting time, it is critical to choose the appropriate diagnostic technique based on the intended outcomes and characteristics of those procedures. Objective: Evaluation of the added value of multislice contrast-enhanced computed tomography in the assessment and characterization of pancreatic lesions compared to endoscopic ultrasound regarding biopsy findings. Patients and Methods: A total of 30 individuals with pancreatic lesions were enrolled and subjected to triphasic CT and endoscopic ultrasound and findings were correlated with results of pathological biopsy findings. Results: Triphasic CT was better than EUS in the detection of vascular invasions especially distant ones that the EUS couldn’t detect them as the left gastric artery, inferior vena cava, left gonadal, and left renal veins. Triphasic CT could demonstrate mass invasion of the superior mesenteric, splenic, and portal veins better than EUS. On the other hand, lesions ≤ 1.5 cm were detected easily by EUS as it detected 7 lesions, while triphasic CT detected only one and the other 6 cases showed bulky pancreatic head. Conclusion: Triphasic CT is more accurate and sensitive than EUS in vascular invasion detection. while EUS is more accurate and sensitive in detecting lesions ≤ 1.5 cm.