To illustrate the role of contrast-enhanced CT in the staging of borderline resectable pancreatic ductal adenocarcinoma (PDAC).
PDAC is the most frequent pancreatic neoplasm (75% of all pancreatic tumors,
90% of pancreatic malignancy).
It is the fourth leading cause of cancer death,
responsible for about 7% of deaths,
with a 5-year survival of around 6% (with a range of 2 to 9%) .
Although radical surgical resection is the only possible curative therapy for PDAC,
less than 20% of newly diagnosed patients undergo surgical resection with curative intent because the vast majority of cancers are already locally...
Findings and procedure details
Among the cross-sectional imaging modalities,
contrast-enhanced CT plays a central role in management of PDAC,
showing high sensibility and specificity for the initial diagnosis of PDAC,
as the tumour appears as a isodense lesion on non-contrast scan (visible only indirectly if it causes dilatation of the main pancreatic duct or atrophy of the pancreas) and hypodense lesion on arterial phase (40 secs,
it may be isodense in 10-15% of cases) and on portal phase (80 sec).
CT can present...
Contrast-enhanced CT allows an accurate pre-operative staging of locally advanced PdAC,
selecting patients who may be candidate for a complete surgical resection.
A multidisciplinary evaluation is needed for patients presenting with “borderline resectable” PdAC.
 Milena Ilic and Irena Ilic (2016) “Epidemiology of pancreatic cancer”World J Gastroenterol.
2016 Nov 28; 22(44): 9694–9705.
doi: 10.3748/wjg.v22.i44.9694  A.
Carrato , A.
Falcone , M.
Ducreux , J.
Valle , A.
Parnaby , K.
Djazouli , K.
Alnwick-Allu , A.
Hutchings , C.
Palaska ,and I.
Parthenaki (2015) “A Systematic Review of the Burden of Pancreatic Cancer in Europe: Real-World Impact on Survival,
Quality of Life and Costs” J Gastrointest Cancer .