• EUS enables the investigator to identify abnormalities 1 cm
or larger. There are small pancreas cancers that can be detected with
EUS that cannot be visualized currently with a CT scan. Technological
improvements are enabling a generation of more accurate images of the
pancreas and such improvements are expected to continue.
• It is the most accurate method for detecting the spread of
cancer to the portal vein (not as accurate for arterial involvement).
• EUS is limited by its relatively low accuracy rate (70%) for
differentiating between PC and localized pancreatitis. EUS will visualize
masses of less than 1 cm but often will not be able to determine whether
the mass is a cancerous. Fine needle aspiration done in conjunction
with EUS may overcome this limitation.
• In one comparative study of diagnostic methods, the sensitivities
for tumors smaller than 3 cm, were 93% EUS, 67% MRI and 53% CT. This
study did not include spiral CT, also called helical, which is more
accurate than conventional CT. (citation)
• The main variable in the success of an EUS investigation is
the experience of the endoscopist. The technique is difficult and the
optimal use of this technique depends on the considerable skill of
the endoscopist. Many centers now have endoscopists trained in the
technique, but EUS is still not available at all medical centers.
