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Review
. 2021 Nov 22;11(11):2166.
doi: 10.3390/diagnostics11112166.

Resectable and Borderline Resectable Pancreatic Ductal Adenocarcinoma: Role of the Radiologist and Oncologist in the Era of Precision Medicine

Federica Vernuccio  1 , Carlo Messina  2 , Valeria Merz  3 , Roberto Cannella  4   5 , Massimo Midiri  4
Affiliations
Review

Resectable and Borderline Resectable Pancreatic Ductal Adenocarcinoma: Role of the Radiologist and Oncologist in the Era of Precision Medicine

Federica Vernuccio et al. Diagnostics (Basel). .

Abstract

The incidence and mortality of pancreatic ductal adenocarcinoma are growing over time. The management of patients with pancreatic ductal adenocarcinoma involves a multidisciplinary team, ideally involving experts from surgery, diagnostic imaging, interventional endoscopy, medical oncology, radiation oncology, pathology, geriatric medicine, and palliative care. An adequate staging of pancreatic ductal adenocarcinoma and re-assessment of the tumor after neoadjuvant therapy allows the multidisciplinary team to choose the most appropriate treatment for the patient. This review article discusses advancement in the molecular basis of pancreatic ductal adenocarcinoma, diagnostic tools available for staging and tumor response assessment, and management of resectable or borderline resectable pancreatic cancer.

Keywords: computed tomography (CT); magnetic resonance imaging (MRI); pancreatic ductal adenocarcinoma; pancreatic neoplasm.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
A 57-year-old man who came to the emergency department for jaundice and abdominal pain. (a,b) US detected a mass in the pancreatic head (white arrow) causing upstream dilatation of the common bile duct (white arrowhead); (c,d) Pancreatic CT scan confirmed the presence of mass in the pancreatic head (*) that caused encasement of the gastroduodenal artery (black arrow) as well as encasement and narrowing of the superior mesenteric-portal venous confluence (black arrowhead), the superior mesenteric vein, and the portal vein.
Figure 2
Figure 2
A 61-year-old man with non-resectable PDAC. Pancreatic CT scan on (a) arterial and (b) portal venous phases shows the presence of a biliary stent (black arrowhead) and a pancreatic mass (*) causing encasement of both superior mesenteric artery (black arrow) and vein (white arrow). The patient commenced modified FOLFIRINOX regimen at diagnosis. However, after 6 months, (c) liver MRI on diffusion weighted imaging showed appearance of liver metastasis in segment IV (arrowhead in c).
See this image and copyright information in PMC

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