Diagnostic Strategy for Differentiating Autoimmune Pancreatitis From Pancreatic Cancer: Is an Endoscopic Retrograde Pancreatography Essential
Kim JH et al. – In patients with suspected autoimmune pancreatitis (AIP), the decision to perform endoscopic retrograde pancreatography (ERP could be tailored to findings on computed tomography (CT).Methods
- Eighty-four AIP patients and 73 pathology-proven pancreatic cancer patients from a prospectively maintained database were retrospectively included.
- Computed tomography and ERP images were reviewed in consensus by 2 blinded radiologists.
- The diagnostic performance of CT alone and combined use of CT and ERP (CT-ERP) were compared.
- The area under the receiver operating characteristic curve of CT-ERP was significantly greater than that of CT alone (0.97 vs 0.87, P < 0.001).
- When patients with AIP were divided into 2 subgroups according to CT features (typical vs atypical), 24 (69%) of 35 AIP patients with atypical CT findings were correctly diagnosed with AIP at CT-ERP and received benefits from additional ERP.
- Endoscopic retrograde pancreatography had little added benefit in patients with typical CT findings for AIP (n = 49), because no alternative diagnoses were established after ERP.