Background/Aim: Detection rates of pancreatic cystic lesions (PCLs) have increased, resulting in a greater need for regularly monitoring these lesions using imaging modalities. We aimed to evaluate the capability of ultrasonography (US) for morphological characterization of PCLs as a reference standard using endoscopic ultrasonography (EUS).
Patients and Methods: A retrospective analysis was conducted of 102 PCLs from 92 patients who underwent US immediately prior to EUS between January 2014 and May 2017. The morphological characteristics of the PCLs, including worrisome features, were compared.
Results: The delineation success rate of PCLs using US was 77.8% for lesions in the head of the pancreas, 91.8% for lesions in the body, and 70.6% for lesions in the tail. The mean size difference between lesions detected using US and EUS was 1.5 mm. An intraclass correlation coefficient value from US for the corresponding EUS size showed very good reliability, with 0.978 (P < 0.001). The sensitivity of US for discriminating unilocular cysts as a reference standard using EUS was 96.8%. The κ value between the US and EUS groups was 0.882 (P < 0.001) for pancreatic duct dilation, indicating good agreement. The κ values for solid components, and cystic wall and septal thickening were 0.481 (P < 0.001), and 0.395 (P < 0.001), respectively, indicating moderate agreement.
Conclusion: US may be useful to monitor PCL growth and changes of the pancreatic duct dilation, but shows limited use in the diagnosis and surveillance of mural nodules or cystic wall thickness changes.