Limitations of EUS in diagnosing CP

What are the limitations of EUS in diagnosing CP? 

  • Interobserver agreement for the diagnosis of CP is moderate with kappa of 0.45; for the individual EUS features of CP, there is poor to moderate agreement, with the highest agreement for ductal dilation and lobularity. 
  • Determination of whether EUS findings are pathologic or represent asymptomatic fibrosis, normal age-related changes, or normal variant is not possible. Asymptomatic EUS changes of CP have been reported in alcoholics, patients of advanced age, and patients who smoke without clinical CP.
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