Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2012 Oct;14(10):658-68.
doi: 10.1111/j.1477-2574.2012.00508.x. Epub 2012 Jun 14.

Multimodality imaging of pancreatic ductal adenocarcinoma: a review of the literature

Shailesh V Shrikhande  1 , Savio George Barreto, Mahesh Goel, Supreeta Arya
Affiliations
Review

Multimodality imaging of pancreatic ductal adenocarcinoma: a review of the literature

Shailesh V Shrikhande et al. HPB (Oxford). 2012 Oct.

Abstract

Background: Accurate pre-operative imaging in pancreatic cancer helps avoid unsuccessful surgical explorations and forewarns surgeons regarding aberrant anatomy. This review aimed to determine the role of current imaging modalities in the diagnosis and determination of resectability of pancreatic and peri-ampullary adenocarcinomas.

Methods: A systematic search of the scientific literature was carried out using EMBASE, PubMed/MEDLINE and the Cochrane Central Register of Controlled Trials for the years 1990 to 2011 to obtain access to all publications, especially randomized controlled trials, reporting on the diagnostic accuracy of ultrasonography, multi-detector computed tomography (MDCT), magnetic resonance imaging (MRI), endoscopic ultrasonography (EUS) or positron emission tomography (PET)-computed tomography (CT) and the evaluation of resectability of pancreatic and peri-ampullary adenocarcinomas.

Results: Based on 66 articles analysed in the review, MDCT and MRI/MRCP have comparable sensitivity and specificity rates for diagnosis and staging of pancreatic cancers. EUS offers the best sensitivity and specificity rates for lesions <2 cm. Improved staging has been noted when PET-CT scans are added to pre-operative evaluation.

Conclusions: MDCT with angiography or MRI/MRCP should constitute the first imaging modality in suspected pancreatic adenocarcinomas. EUS is recommended for assessing lesions not clearly detected, but suspected, on CT/MRI and in tumours considered 'borderline resectable' on MDCT to assess vascular involvement. PET-CT in locally advanced lesions will help rule out distant metastases.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Flow chart of the search strategy employed
Figure 2
Figure 2
Algorithm outlining the role of the individual imaging modalities in the management of pancreatic and peri-ampullary cancers. MDCT, multi-detector computed tomography; MRI, magnetic resonance imaging; MRCP, magnetic resonance cholangiopancreatography; PET-CT, positron emission tomography-computed tomography; EUS, endoscopic ultrasonography; ERCP, endoscopic retrograde cholangiopancreatography
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Cancer Facts and Figures. American Cancer Society. 2009. Available at http://www.cancer.org/acs/groups/content/@nho/documents/document/500809w... (last accessed 8 June 2012)
    1. Cancer Research UK. Available at http://info.cancerresearchuk.org/cancerstats/types/pancreas/incidence/ (last accessed 8 June 2012)
    1. Chen KX, Wang PP, Zhang SW, Li LD, Lu FZ, Hao XS. Regional variations in mortality rates of pancreatic cancer in China: results from 1990–1992 national mortality survey. World J Gastroenterol. 2003;9:2557–2560. - PMC - PubMed
    1. Seino T, Nakadaira H, Endoh K, Yamamoto M. Changes in pancreatic cancer mortality, period patterns, and birth cohort patterns in Japan: analysis of mortality data in the period 1968–2002. Environ Health Prev Med. 2008;13:234–242. - PMC - PubMed
    1. Paez D, Labonte M, Lenz H. Pancreatic Cancer: medical management (novel chemotherapeutics) Gastroenterol Clin North Am. 2012;41:189–209. - PubMed

MeSH terms