Comparison between CT and CEUS in the diagnosis of pancreatic adenocarcinoma

Purpose: To compare CEUS and CT features of pancreatic ductal adenocarcinoma in relation to tumour size. Methods and Materials: 133 patients with pathological diagnosis of pancreatic adenocarcinoma, studied with CEUS and MDCT, have been enrolled. Two radiologists evaluated tumour size, site and imaging appearance. Sensitivity of the two methods was compared using McNemar test. Results: In 9/133 patients neither MDCT nor US/CEUS could identify the lesion; in 9/133 patients only MDCT and in 13/133 only US/CEUS could identify the lesion. In the remaining 102 patients, both MDCT and US/CEUS were positive. US/CEUS sensitivity was 86.47%, while MDCT was 83.58%, with no statistically significant difference (p=0.523). For lesions smaller than 2 cm US/CEUS sensitivity was 100 %, while MDCT sensitivity was 73.33% with no significant difference (p=0.125). For lesions between 2.1 and 3 cm US/CEUS had a sensitivity of 95.35%, while MDCT had a sensitivity of 83.72% with no significant difference, p=0.180). For lesions between 3.1 and 4 cm, US/CEUS had a sensitivity of 87.88%, while MDCT had a sensitivity of 93.94% with no significant difference (p=0.688). For lesions larger than 4 cm, US/CEUS had a sensitivity of 90.91%, while MDCT had a sensitivity of 100 % with no statistically significant difference (p=0.250). Conclusion: US/CEUS sensitivity in diagnosing pancreatic adenocarcinoma does not statistically differ from that of MDCT. US/CEUS sensitivity seems to be higher for small lesions, while MDCT sensitivity is higher for large lesions. By combining both the imaging methods a higher accuracy in diagnosing pancreatic carcinoma can be expected.