Diagnostic Accuracy of Transabdominal Ultrasound and Computed Tomography in Chronic Pancreatitis: A Head-to-Head Comparison

Ingrid Kvåle Nordaas; Trond Engjom; Odd Helge Gilja; Roald Flesland Havre; Dag André Sangnes; Ingfrid S Haldorsen; Georg Dimcevski

doi:10.1055/a-1542-9146

Diagnostic Accuracy of Transabdominal Ultrasound and Computed Tomography in Chronic Pancreatitis: A Head-to-Head Comparison

Ultrasound Int Open. 2021 Apr;7(1):E35-E44. doi: 10.1055/a-1542-9146. Epub 2021 Aug 24.

Authors

Ingrid Kvåle Nordaas^{1

2}, Trond Engjom^{1

2}, Odd Helge Gilja^{1

2}, Roald Flesland Havre^{1

2}, Dag André Sangnes^{1

2}, Ingfrid S Haldorsen^{2

3}, Georg Dimcevski^{1

2}

Affiliations

¹ National Centre for Ultrasound in Gastroenterology, Department of Medicine, Helse Bergen HF, Haukeland University Hospital, Bergen, Norway.
² Department of Clinical Medicine, University of Bergen, Bergen, Norway.
³ Mohn Medical Imaging and Visualization Centre, Department of Radiology, Helse Bergen HF, Haukeland University Hospital, Bergen, Norway.

Abstract

Purpose Computed tomography (CT) is the most used imaging modality for diagnosing chronic pancreatitis (CP), but advances in transabdominal ultrasound (US) technology have given US a position as a viable alternative. We aimed to evaluate the diagnostic accuracy of abdominal CT and pancreatic US compared to the reference standard, a modified Mayo score. Materials and Methods CT, US, and endoscopic ultrasound (EUS) were performed in patients referred due to suspected CP. The modified Mayo score included EUS results, clinical presentation, and results from exocrine and endocrine pancreatic function tests. We scored CT findings according to the modified Cambridge classification and US findings according to the Rosemont classification. Results In total, 73 patients were included. 53 patients (73%) were categorized as CP and 20 (27%) as non-CP. CT and US yielded similar sensitivities (68% and 64%, respectively) and specificities (75 and 85%, respectively) and similar areas under the receiver operating characteristic curves for diagnosing CP. We found no significant differences between the areas under the receiver operating characteristic curves (AUROCs) for CT (AUROC 0.75, 95% CI 0.63-0.87) and US (AUROC 0.81, 95% CI 0.71-0.91). Conclusion We conclude that CT and US had comparable, moderate accuracy in diagnosing CP. Neither modality had high enough sensitivity to exclude the diagnosis as a standalone method.

Keywords: CT; chronic pancreatitis; pancreas; pancreatitis; ultrasound.

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