Abdominal US for diagnosis of pancreatic tumor: prospective cohort analysis

Radiology. 1999 Oct;213(1):107-11. doi: 10.1148/radiology.213.1.r99oc25107.


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 1988-1990, data on malignant disease and survival were analyzed by using the Swedish Death and Cancer Registries. Nine hundred nineteen patients were entered into the analysis. In 140 of them, a clinical diagnosis of tumor in the 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 pancreatic area was 88.6% (124 of 140 patients), which was similar to that for the detection of exocrine pancreatic cancer, 90% (79 of 88 patients). There were nine false-positive US examinations, for a specificity of 98.8% (770 of 779 patients). Systematic sampling of 94 investigations confirmed an association 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 its performance.

MeSH terms

  • Abdomen / diagnostic imaging*
  • Common Bile Duct Neoplasms / diagnostic imaging
  • Duodenal Neoplasms / diagnostic imaging
  • Female
  • Humans
  • Male
  • Middle Aged
  • Observer Variation
  • Pancreatic Neoplasms / diagnostic imaging*
  • Pancreatic Neoplasms / secondary
  • Prospective Studies
  • Sensitivity and Specificity
  • Ultrasonography