Initial Diagnosis and Staging of Pancreatic Cancer Including Main Differentials

Semin Ultrasound CT MR. 2019 Dec;40(6):436-468. doi: 10.1053/j.sult.2019.08.001. Epub 2019 Aug 30.

Abstract

Computed tomography (CT) remains the optimal imaging modality for both diagnosis and staging of pancreatic adenocarcinoma. Especially, CT is highly accurate in assessing the relationship of the tumor to critical arterial and venous structures, since their involvement can preclude surgical resection or indicate a neoadjuvant strategy in borderline resectable or locally advanced lesions. MRI provides additional staging information in isodense tumors or regarding presence of small liver metastases not seen at CT. Endoscopic ultrasound is the reference technique to be used for obtaining histologic proof. The introduction of perfusion modalities and radiomics may benefit the evaluation of pancreatic lesion parameters, thus helping to rule out differentials. However, these techniques require further investigation and standardization.

Publication types

  • Review

MeSH terms

  • Biomarkers, Tumor / blood
  • Contrast Media
  • Diagnosis, Differential
  • Endosonography
  • Humans
  • Magnetic Resonance Imaging
  • Neoplasm Staging
  • Pancreatic Neoplasms / diagnostic imaging*
  • Pancreatic Neoplasms / pathology
  • Risk Factors
  • Tomography, X-Ray Computed

Substances

  • Biomarkers, Tumor
  • Contrast Media