A comparative study of computed tomography and ERCP in pancreaticobiliary disease

      This paper is only available as a PDF. To read, Please Download here.


      Fifty-seven patients with suspected pancreaticobiliary pathology constituting a clinical subset in whom the diagnosis was problematic or nonspecific were evaluated with computed tomography and ERCP. The relative sensitivities, specificities, and accuracies of the two tests were compared. Computed tomography was successful in obtaining a diagnostic examination in 100% and ERCP was technically successful in 75%. Both tests were equally accurate in detecting an abnormality (computed tomography 95.7%; ERCP 95.3%) and offering a correct diagnosis (computed tomography 72%; ERCP 70%). Sensitivity and specificity of the two tests for detection of an abnormality was computed tomography 100% and 91.3#/,; ERCP 91.7% and 100%. Sensitivity and specificity for the correct diagnosis was computed tomography 59% and 91.3%; ERCP 46% and 100%. Computed tomography was also superior to ERCP in making a correct diagnosis in pancreatic carcinoma (80% versus 63%) and pancreatitis (75% versus 50%,). Based on these results we conclude that computed tomography utilizing high doses of intravenous contrast material and thin collimation is the preferred screening examination for pancreaticobiliary disease. ERCP should be reserved for those cases where the pancreaticobiliary disease. ERCP should be reserved for those cases where the diagnosis on computed tomography is obscure or uncertain and/or the pancreatic or biliary ductal anatomy requires direct contrast imaging.


      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'


      Subscribe to Clinical Imaging
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect


        • Moosa A.R.
        • Levin B.
        Diagnosis of “early” pancreatic cancer.
        Cancer. 1981; 47: 1688
        • Bernardino M.E.
        • Barnes P.A.
        Imaging the pancreatic neoplasm.
        Cancer. 1982; 50: 2681-2688
        • Yankaskas B.C.
        • Staab E.Y.
        • Rudnick S.A.
        • et al.
        The radiologic diagnosis of pancreatic cancer: The effect of new imaging techniques.
        Invest Radiol. 1985; 20: 73-78
        • Ferrucci Jr, J.T.
        • Wittenberg J.
        • Black E.B.
        • et al.
        Computed tomography in chronic pancreatitis.
        Radiology. 1979; 130: 175-182
        • Gayler B.W.
        • Milligan F.D.
        Computed tomography and endoscopic retrograde cholangiography: comparison.
        in: Siegelman S.S. Computed Tomography of the Pancreas. Churchill Livingstone, New York1983: 214-246
        • Moss A.A.
        • Federle M.
        • Shapiro H.A.
        • et al.
        The combined use of computed tomography and endoscopic retrograde cholangiopancreatography in the assessment of suspected pancreatic neoplasm: A blind clinical evaluation.
        Radiology. 1980; 134: 159-163
        • Foley W.D.
        • Stewart E.T.
        • Lawson T.L.
        • et al.
        Computed tomography, ultrasonography, and endoscopic retrograde cholangiopancreatography in the diagnosis of pancreatic disease: A comparative study.
        Gastrointest Radiol. 1980; 5: 29-35
        • Frick M.P.
        • Feinberg S.B.
        • Goodale R.L.
        The value of endoscopic retrograde cholangiopancreatography in patients with suspected carcinoma of the pancreas and indeterminate computed tomographic results.
        Surg Gynecol Obstet. 1982; 155: 177-182
        • Frick M.P.
        • O'Leary J.F.
        • Walker Jr, H.C.
        Accuracy of endoscopic retrograde cholangiopancreatography (ERCP) in differentiating benign and malignant pancreatic disease.
        Gastrointest Radiol. 1982; 7: 241-244
        • Freeny P.C.
        • Marks W.M.
        • Ball T.J.
        Impact of high-resolution computed tomography of the pancreas on utilization of endoscopic retrograde cholangiopancreatography and angiography.
        Radiology. 1982; 142: 35-39
        • Bilbao M.K.
        • Katon R.M.
        Neoplasms of the pancreas.
        in: Stewart E.T. Venues J.A. Atlas of Endoscopic Retrograde Cholangiopancreatography. Mosby, St Louis1977: 181-192
        • Ralls P.W.
        • Halls J.
        • Renner I.
        Endoscopic retrograde cholangiopancreatography (ERCP) in pancreatic disease.
        Radiology. 1980; 134: 347-352
        • Varley P.F.
        • Rohrmann Jr, C.A.
        • Silvus S.E.
        • et al.
        The normal endoscopic pancreatogram.
        Radiology. 1976; 118: 295-300
        • Plumby T.F.
        • Rohrmann C.A.
        • Freeny P.C.
        • et al.
        Double duct sign: Reassessed significance in ERCP.
        AJR. 1982; 138: 31-35
        • Karasawa E.
        • Goldberg H.I.
        • Moss A.A.
        • et al.
        CT pancreacogram in carcinoma of the pancreas and chronic pancreatitis.
        Radiology. 1983; 148: 489-493
        • Itai Y.
        • Araki T.
        • Tasaka A.
        • et al.
        Computed tomographic appearance of resectable pancreatic carcinoma.
        Radiology. 1982; 143: 245-249
        • Jafri S.Z.
        • Aisen A.M.
        • Glazer G.M.
        • et al.
        Comparison of CT and angiography in assessing resectability of pancreatic carcinoma.
        AJR. 1984; 142: 525-529