Diagnosing pancreatic cancer: the role of percutaneous biopsy and CT
| Autor: | C.V. House, B. Theis, R.C.G. Russell, William R. Lees, M. Novelli, Zahir Amin |
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| Rok vydání: | 2006 |
| Předmět: |
Adult
medicine.medical_specialty Pancreatic disease Biopsy Adenocarcinoma Malignancy Sensitivity and Specificity Predictive Value of Tests Pancreatic cancer medicine Pancreatic mass Humans Radiology Nuclear Medicine and imaging False Negative Reactions Aged Retrospective Studies Aged 80 and over Pancreatic duct medicine.diagnostic_test business.industry General Medicine Middle Aged medicine.disease Pancreatic Neoplasms medicine.anatomical_structure Predictive value of tests Radiology Tomography X-Ray Computed business |
| Zdroj: | Clinical Radiology. 61:996-1002 |
| ISSN: | 0009-9260 |
| DOI: | 10.1016/j.crad.2006.07.005 |
| Popis: | Aims To determine the sensitivity and complications of percutaneous biopsy of pancreatic masses, and whether typical computed tomography (CT) features of adenocarcinoma can reliably predict this diagnosis. Materials and methods A 5 year retrospective analysis of percutaneous core biopsies of pancreatic masses and their CT features was undertaken. Data were retrieved from surgical/pathology databases; medical records and CT reports and images. Results Three hundred and three patients underwent 372 biopsies; 56 of 87 patients had repeat biopsies. Malignancy was diagnosed in 276 patients, with ductal adenocarcinoma in 259 (85%). Final sensitivity of percutaneous biopsy for diagnosing pancreatic neoplasms was 90%; for repeat biopsy it was 87%. Complications occurred in 17 (4.6%) patients, in three of whom the complications were major (1%): one abscess, one duodenal perforation, one large retroperitoneal bleed. CT features typical of ductal adenocarcinoma were: hypovascular pancreatic mass with bile and/or pancreatic duct dilatation. Atypical CT features were: isodense or hypervascular mass, calcification, non-dilated ducts, cystic change, and extensive lymphadenopathy. Defining typical CT features of adenocarcinoma as true-positives, CT had a sensitivity of 68%, specificity of 95%, positive predictive value (PPV) of 98%, and negative predictive value of 41% for diagnosing pancreatic adenocarcinoma. Conclusion Final sensitivity of percutaneous biopsy for establishing the diagnosis was 90%. CT features typical of pancreatic adenocarcinoma had high specificity and PPV. On some occasions, especially in frail patients with co-morbidity, it might be reasonable to assume a diagnosis of pancreatic cancer if CT features are typical, and biopsy only if CT shows atypical features. |
| Databáze: | OpenAIRE |
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