Department of Gastroenterology, Juntendo University
A prospective comparison of US, CT, ERCP and angiography was performed in 112 patients with proven pancreatic carcinoma. ERCP had the highest sensitivity and specificity. CT was the least sensitive. Angiography had the highest positive predictive value. US and ERCP had a high negative predictive value. The initial examination of a patient with suspected pancreatic carcinoma is by US. Should this be abnormal, CT is used to confirm a lesion. The diagnosis of unresectable pancreatic carcinoma could be made by US and CT without the need for additional imaging procedure. If not, ERCP is indicated when there is some distinct reason to suspect pancreatic carcinoma. If ERCP reveals an abnormality, angiography is performed whether the lesion is benign or malignant, and if malignant it is resectable or not.