Limitation of CT in diagnosis of pancreatic cancer.

The differentiation of pancreatic abnormalities remains a problem. We analyzed the sensitivity and specificity of computed tomography (CT) in the diagnosis of pancreatic disease, using six radiologists who had less than six months' training in CT (resident level: inexperienced) and six who had more than 12 months' training (staff level: experienced) in order to clarify the difficulty with CT in the qualitative diagnosis of pancreatic cancer. We reviewed retrospectively 100 cases: 28 cases of pancreatic cancer, 15 of chronic pancreatitis, three of acute pancreatitis, 12 of neoplastic disease that involved the pancreas, and 42 normal subjects. The average sensitivity and specificity of CT in the diagnosis of pancreatic disease were 81.3% and 84.4%, respectively, for the experienced radiologists and 64.0% and 82.1%, respectively, for the inexperienced radiologists. The averages for pancreatic cancer were 65.3% and 87.8% for the experienced radiologists and 60.7% and 87.3% for the inexperienced radiologists. We conclude that the ability to detect pancreatic abnormalities improves with training and experience, but diagnosis of pancreatic cancer does not improve after a certain level of expertise.