Imaging Diagnosis of Pancreatic Cancer: CT and MRI

Abstract

Pancreatic cancer (PC) remains one of the deadliest cancers worldwide, with a poor survival rate. Although complete surgical resection remains the only potential curative therapy for pancreatic cancer, less than 20% of the patients newly diagnosed with pancreatic cancer undergo surgical resection with a curative intent. This is mainly due to the lack of early symptoms and the tendency of pancreatic adenocarcinoma to invade adjacent structures or to metastasize at an early stage. Imaging studies play a critical role for evaluation of the extent of disease and staging, which is of great importance to make adequate selection for surgical candidate. Currently, the diagnosis of PC relies on computed tomography (CT) and/or magnetic resonance imaging (MRI) with magnetic resonance cholangiopancreatography (MRCP), or biopsy, or fine-needle aspiration (FNA) using endoscopic ultrasound (EUS). Although MDCT currently has a major role in the evaluation of PC, multiparametric MRI with diffusion-weighted imaging and MRCP allows a comprehensive analysis of the morphological changes of the pancreatic parenchyma as well as the pancreatic duct and can be used as a problem-solving tool. Positron emission tomography (PET) techniques could be used in special conditions in which CT and EUS are not completely diagnostic. It is essential for clinicians to understand the advantages and disadvantages of the various pancreatic imaging modalities in order to be able to make optimal treatment management decisions.