Role of endoscopic ultrasound versus computed tomography in diagnosis of pancreatic focal lesions

Objectives To compare the accuracy of endoscopic ultrasound (EUS) and computed tomography (CT) in diagnosing pancreatic focal lesions as regarding location, size, nature, nodal staging, vascular invasion, and distant metastases. Background Pancreatic cancer (PC) is one of the deadliest cancers all over the world, the appropriate screening and early diagnosis of PC is quite challenging. EUS was introduced in the clinical field for better identification of the pancreas. Patients and methods This study was done on 44 patients with indeterminate pancreatic lesions from December 2018 to December 2019. Patients with pancreatic lesions were identified incidentally through imaging such as US, CT, MRI, or clinical manifestations, for example, jaundice. CT and EUS with or without fine-needle aspiration were done for all participants. Results This study showed that the detection rate for pancreatic focal lesions (PC) by EUS was 97.7%, with good detection for tumors less than 2 cm in diameter. EUS is an accurate preoperative tool in assessing regional nodal staging with 65.9 and 50% for CT, and also regarding vascular-invasion respectability in patients with pancreatic adenocarcinoma. CT has the upper hand in detection of distant pancreatic metastasis. Conclusion EUS helps in early detection of PC, thus, it would decrease the morbidity and mortality. EUS–fine-needle aspiration establishes the tumor type with high accuracy and fewer complications, and useful for differential diagnosis. EUS staging should be the standard of care along with CT to diagnose and to evaluate the patients with PC preoperatively.