Diagnostic Accuracy of Computed Tomography Scores in Chronic Pancreatitis. Issue 4 (April 2021)

• Record Type: Journal Article
• Authors: Nordaas, Ingrid Kvåle; Dimcevski, Georg; Gilja, Odd Helge; Havre, Roald Flesland; Haldorsen, Ingfrid S.; Engjom, Trond
• Is Part Of: Pancreas. Volume 50:Issue 4(2021)
• Publication Date: 2021-04
• Subjects: chronic pancreatitis -- computed tomography -- diagnostic accuracy -- diagnostic imaging -- pancreas -- sensitivity and specificity -- AUROC - area under the receiver operating characteristic curve -- CP - chronic pancreatitis -- CT - computed tomography -- ERP - endoscopic retrograde pancreatography -- EUS - endoscopic ultrasonography -- MRI - magnetic resonance imaging -- ROC - receiver operating characteristic curve -- US - transabdominal ultrasound; Pancreas -- Diseases -- Periodicals; Pancreas -- Periodicals; Neuroendocrine tumors -- Periodicals; 616.37005
• DOI: 10.1097/MPA.0000000000001803
• Languages: English
• ISSNs: 0885-3177

Abstract

Abstract : Objectives: Computed tomography (CT) is the most commonly used imaging modality when diagnosing chronic pancreatitis (CP). We aimed to evaluate the diagnostic accuracy of CT scores for diagnosing CP. Methods: One hundred eighteen patients were retrospectively included from an observational cohort study that comprised patients referred because of suspected CP. Patients were categorized as CP or non-CP using a modified Mayo score based on biochemistry, clinical presentation, and findings on endoscopic ultrasound and/or transabdominal ultrasound. The CT scans were scored according to the modified Cambridge classification and the unweighted CT score. Diagnostic performance indices were calculated using the modified Mayo score as reference standard. Results: Seventy-six of the 118 patients fulfilled the CP diagnostic criteria (Mayo score ≥4). The modified Cambridge classification and the unweighted CT score yielded sensitivities of 63% and 67% and specificities of 91% and 91%, respectively, and similar areas under the receiver operating characteristic curves (95% confidence interval) of 0.79 (0.71–0.88)/0.81 (0.73–0.89), respectively ( P, not significant). Conclusions: Both CT scores had similar, moderate accuracies for diagnosing CP. The limitation in diagnostic accuracy makes CT ineligible as a single method to diagnose CP, supporting that the diagnostic process for CP needs to incorporate other imaging methods and/or markers for better diagnostics.