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Medline ® Abstract for Reference 31

of 'Clinical manifestations, diagnosis, and staging of exocrine pancreatic cancer'

31
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Abdominal US for diagnosis of pancreatic tumor: prospective cohort analysis.
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Karlson BM, Ekbom A, Lindgren PG, Källskog V, Rastad J
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Radiology. 1999;213(1):107.
 
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.
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Department of Surgery, University Hospital, Uppsala, Sweden. Britt-Marie.Karlson@Kirurgi.uu.se
PMID