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.