Diagnostic accuracy of ultrasound, computed tomography and endoscopic retrograde cholangiopancreatography in the detection of pancreatic cancer in patients with jaundice or cholestasis.

A prospective study of jaundiced and/or cholestatic patients (N = 220) was carried out to evaluate the diagnostic accuracy of ultrasound (US), computed tomography (CT) and endoscopic retrograde cholangiopancreatography (ERCP) in the detection of pancreatic cancer. Thirty-one patients had the final diagnosis of pancreatic cancer and two patients had a cancer of the papilla of Vater. The sensitivities of US, CT and ERCP were 60%, 97%, 89% and specificities were 92%, 92%, 94%, respectively. The differences in sensitivity between US and other methods were statistically significant (US vs. CT p less than 0.01, US vs. ERCP p less than 0.05). In US studies, most false negative results were caused by unsatisfying visualization. On the basis of this study, we recommend CT as a diagnostic test of pancreatic cancer, if pancreatic cancer is suspected as a cause of jaundice and/or cholestasis.