International Journal of Radiation Research

en Accuracy of endoscopic ultrasonography plus abdominal CT versus plus MRI in differentiating benign from malignant pancreatic space-occupying lesions Radiation Biology Radiation Biology تحقيق بديع Original Research <div style="text-align: justify;">Background: Pancreatic space-occupying lesions (PSOLs) represent common yet complex digestive disorders. Current studies focus on endoscopic ultrasonography (EUS) combined with single imaging modality, but direct comparisons between these combination strategies are limited. This study assesses the comparative diagnostic effectiveness of EUS with abdominal computed tomography (CT) versus EUS paired with magnetic resonance imaging (MRI) in distinguishing benign from malignant pancreatic space-occupying lesions (PSOLs), to inform refined clinical diagnostic approaches. Materials and Methods: This prospective study enrolled 158 patients with suspected PSOLs from May 2024 to March 2025. Participants were assigned to either EUS+CT (n=84) or EUS+MRI (n=74) group. The diagnostic accuracy of these combinatorial strategies for PSOLs was appraised against the gold standard (pathological section results or puncture biopsy findings). Additionally, subgroup analyses were conducted on subgroups featuring small lesions (≤2 cm in diameter) or mucinous cystic neoplasms (MCNs). Results: The gold standard confirmed 127 patients to have PSOLs. For EUS + CT, the diagnostic sensitivity, specificity, and accuracy for PSOLs were 72.31%, 63.16%, and 70.24%, respectively, with a Kappa (κ) value of 0.646 (P<0.05). In comparison, EUS combined with MRI showed superior performance with 82.26% sensitivity, 83.33% specificity, and 82.43% accuracy (κ=0.802, P<0.05). Subgroup analysis further indicated that the EUS-MRI strategy was significantly more effective in detecting small lesions and MCNs than the EUS-CT approach (P<0.05). Conclusion: EUS paired with MRI may provide more accurate diagnoses than EUS plus CT in most cases, particularly for small lesions and MCNs, while EUS-CT retains value in specific scenarios.</div> Endoscopic ultrasonography, computed tomography, magnetic resonance imaging, pancreatic space-occupying lesions. 813 818 http://ijrr.com/browse.php?a_code=A-10-1-1581&slc_lang=en&sid=1 R. Yang 7900319475328460034427 7900319475328460034427 No Magnetic Resonance Room, Zhoukou Central Hospital of Henan Medical University, Zhoukou, Henan, China J. Guo 7900319475328460034428 7900319475328460034428 No Magnetic Resonance Room, Zhoukou Central Hospital of Henan Medical University, Zhoukou, Henan, China L. Yuan 7900319475328460034429 7900319475328460034429 No Magnetic Resonance Room, Zhoukou Central Hospital of Henan Medical University, Zhoukou, Henan, China Z. Wang 7900319475328460034430 7900319475328460034430 No Magnetic Resonance Room, Zhoukou Central Hospital of Henan Medical University, Zhoukou, Henan, China S. Liu 7900319475328460034431 7900319475328460034431 No Magnetic Resonance Room, Zhoukou Central Hospital of Henan Medical University, Zhoukou, Henan, China Y. Sun 16650077927@163.com 7900319475328460034432 7900319475328460034432 Yes Magnetic Resonance Room, Zhoukou Central Hospital of Henan Medical University, Zhoukou, Henan, China