Learning objectives
To revise the radiologic evaluation of patients with pancreatic cancer for initial staging,
response to neoadjuvant chemotheraphy,
follow up after treatment and findings related to surgical and interventional procedures.
Background
Pancreatic carcinoma is the second most frequent digestive tumour [1-4].
Pancreatic ductal adenocarcinoma (PDAC),
originated from the exocrine pancreas,
is the most frequent histological type of pancreatic carcinoma and represents 95% of these neoplasms [5,6].
It is the fourth cause of oncologic death in developed countries [6,7].
At the time of the diagnosis,
40-50% of the cases have metastases,
and about 40% of the patients suffer from a locally advanced disease,
in which surgery is not indicated [8].
Nowadays,
complete surgical resection is the only...
Findings and procedure details
Staging using multidetector computerized tomography:
The standard study protocol through MDCT for the pancreatic assessment requires at least one biphasic scan,
which includes a pancreatic parenchymal phase and a venous phase [16,
17].
Optionally,
a basal acquisition without contrast administration can be done (Table 1).
The pancreatographic parenchymal phase provides maximum parenchymal enhancement and an optimal visual contrast between the enhanced parenchyma and the tumour,
which is normally hypodense [3].
This phase also shows an enhancement of the arterial vessels,
which allows a concomitant evaluation...
Conclusion
The ability to diagnose pancreatic carcinoma has been rapidly improving with the recent advances in diagnosis techniques.
MDCT and MRI are the key stones and radiologist must be aware of imaging protocols,
standardized terms and critical points for structures reporting to accommodate the best therapeutic strategy.
Personal information
Radiology department,
Complejo Hospitalario de Navarra.
Calle Irunlarrea 3.
PC 31008.
Pamplona,
Spain.
References
Shown in figures 14 and 15.