A retrospective study was performed on all patients with clinical suspicion of a pancreatic cancer over a seven-month period. Diagnostic scans of the pancreas were obtained in 87% of the patients. Of 112 patients with a successful ultrasound study, 97 had adequate clinical or surgical follow up. The ultrasound examination was abnormal in 16 of 17 pancreatic cancer patients, yielding a positive predictive value of 84%. Most patients had distant spread at this time. The negative predictive value was 99%, sensitivity was 94%, specificity 96%. This study does not suggest that ultrasound leads to an earlier diagnosis of pancreatic cancer. However, because the symptoms of the disease are common in the elderly, ultrasound allows reliable exclusion of this disease in a noninvasive way.
Cancer 47:1662-1665, 1981.
HE PROGNOSIS for patients with pancreatic cancer
T remains poor because the disease is usually far advanced by the time a patient becomes symptomatic. Until recent years, radiologic tools were incapable of displaying the pancreas itself and the presence of late stage cancer was inferred from distortion of surrounding opacified viscera. In the past decade, several imaging techniques have been introduced that permit direct imaging of the pancreas and greater accuracy in detecting pathology. Gray-scale ultrasound, x-ray computerized tomography, and endoscopic retrograde cholangiopancreatography all introduce the possibility of earlier detection of pancreatic cancer if performed at the earliest symptoms of pancreatic dysfunction. Because these early symptoms of weight loss, back pain, anorexia, and nausea are common with the elderly population at risk, a noninvasive test is desirable because the positive yield is low.
Ultrasound is now widely regarded as the screening procedure of choice for diagnosing pancreatic carcinoma.1*4*5 Pancreatic size, contour, and parenchymal consistency can be displayed readily. Furthermore, ultrasound examination is noninvasive, involves no