Computed Tomography versus Endoscopic Ultrasonography for Staging of Pancreatic Cancer
Authors: William M. Tierney, Michael L. Kochman, James M. Scheiman
Journal: Annals of Internal Medicine (2005)

Letters5 April 2005Computed Tomography versus Endoscopic Ultrasonography for Staging of Pancreatic CancerWilliam M. Tierney, MD, Michael L. Kochman, MD, and James M. Scheiman, MDWilliam M. Tierney, MDFrom University of Oklahoma Health Sciences Center, Oklahoma City, OK 73104; Hospital of the University of Pennsylvania, Philadelphia, PA 19104; and University of Michigan Medical Center, Ann Arbor, MI 48109.Search for more papers by this author, Michael L. Kochman, MDFrom University of Oklahoma Health Sciences Center, Oklahoma City, OK 73104; Hospital of the University of Pennsylvania, Philadelphia, PA 19104; and University of Michigan Medical Center, Ann Arbor, MI 48109.Search for more papers by this author, and James M. Scheiman, MDFrom University of Oklahoma Health Sciences Center, Oklahoma City, OK 73104; Hospital of the University of Pennsylvania, Philadelphia, PA 19104; and University of Michigan Medical Center, Ann Arbor, MI 48109.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-142-7-200504050-00019 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:We congratulate DeWitt and colleagues on their article comparing endoscopic ultrasonography and multidetector computed tomography (CT) for detection and staging of pancreatic cancer (1). However, we would like to highlight an inaccuracy and indicate limitations that should temper acceptance of their conclusions into current patient care.The authors incorrectly stated that the University of Michigan study (2) comparing endoscopic ultrasonography with helical CT included patients with distant metastatic disease. Mertz and associates (3) did include 9 patients with metastatic disease in their study.Our concerns relate to the authors' primary outcome: detection of unresectability. Tumors were deemed ...References1. DeWitt J, Devereaux B, Chriswell M, McGreevy K, Howard T, Imperiale TF, et al. Comparison of endoscopic ultrasonography and multidetector computed tomography for detecting and staging pancreatic cancer. Ann Intern Med. 2004;141:753-63. [PMID: 15545675] LinkGoogle Scholar2. Tierney WM, Francis IR, Eckhauser F, Elta G, Nostrant TT, Scheiman JM. The accuracy of EUS and helical CT in the assessment of vascular invasion by peripapillary malignancy. Gastrointest Endosc. 2001;53:182-8. [PMID: 11174289] CrossrefMedlineGoogle Scholar3. Mertz HR, Sechopoulos P, Delbeke D, Leach SD. EUS, PET, and CT scanning for evaluation of pancreatic adenocarcinoma. Gastrointest Endosc. 2000;52:367-71. [PMID: 10968852] CrossrefMedlineGoogle Scholar4. Tierney WM, Fendrick AM, Hirth RA, Scheiman JM. The clinical and economic impact of alternative staging strategies for adenocarcinoma of the pancreas. Am J Gastroenterol. 2000;95:1708-13. [PMID: 10925972] CrossrefMedlineGoogle Scholar5. Kochman ML. EUS in pancreatic cancer. Gastrointest Endosc. 2002;56:S6-S12. [PMID: 12297741] CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: From University of Oklahoma Health Sciences Center, Oklahoma City, OK 73104; Hospital of the University of Pennsylvania, Philadelphia, PA 19104; and University of Michigan Medical Center, Ann Arbor, MI 48109. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoComparison of Endoscopic Ultrasonography and Multidetector Computed Tomography for Detecting and Staging Pancreatic Cancer John DeWitt , Benedict Devereaux , Melissa Chriswell , Kathleen McGreevy , Thomas Howard , Thomas F. Imperiale , Donato Ciaccia , Kathleen A. Lane , Dean Maglinte , Kenyon Kopecky , Julia LeBlanc , Lee McHenry , James Madura , Alex Aisen , Harvey Cramer , Oscar Cummings , and Stuart Sherman Computed Tomography versus Endoscopic Ultrasonography for Staging of Pancreatic Cancer John M. DeWitt , Thomas F. Imperiale , and Stuart Sherman Metrics Cited byFacile Fabrication of BiF3: Ln (Ln = Gd, Yb, Er)@PVP Nanoparticles for High-Efficiency Computed Tomography ImagingEndoscopic Ultrasound: Introduction and How to Educate OperatorsComparison of ERCP, EUS, and ERCP combined with EUS in diagnosing pancreatic neoplasms: a systematic review and meta-analysisThe role of routine preoperative EUS when performed after contrast enhanced CT in the diagnostic work-up in patients suspected of pancreatic or periampullary cancerThe concept of bedside EUSRole of EUS 5 April 2005Volume 142, Issue 7Page: 590KeywordsComputed axial tomographyCurative resectionDecision makingForecastingLiverPancreasPancreatic cancerPatientsUltrasound imagingVascular diseases ePublished: 5 April 2005 Issue Published: 5 April 2005 Copyright & PermissionsCopyright © 2005 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...