Imaging diagnosis of pancreatic cancer: a state-of-the-art review

World J Gastroenterol. 2014 Jun 28;20(24):7864-77. doi: 10.3748/wjg.v20.i24.7864.

Abstract

Pancreatic cancer (PC) remains one of the deadliest cancers worldwide, and has a poor, five-year survival rate of 5%. Although complete surgical resection is the only curative therapy for pancreatic cancer, less than 20% of newly-diagnosed patients undergo surgical resection with a curative intent. Due to the lack of early symptoms and the tendency of pancreatic adenocarcinoma to invade adjacent structures or to metastasize at an early stage, many patients with pancreatic cancer already have advanced disease at the time of their diagnosis and, therefore, there is a high mortality rate. To improve the patient survival rate, early detection of PC is critical. 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 using endoscopic ultrasound (EUS). Although multi-detector row computed tomography currently has a major role in the evaluation of PC, MRI with MRCP facilitates better detection of tumors at an early stage by allowing a comprehensive analysis of the morphological changes of the pancreas parenchyma and pancreatic duct. The diagnosis could be improved using positron emission tomography techniques 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 and management decisions. Our study investigates the current role and innovative techniques of pancreatic imaging focused on the detection of pancreatic cancer.

Keywords: Endoscopic ultrasound-guided fine needle aspiration; Magnetic resonance imaging; Multi-detector computed tomography; Pancreatic neoplasms; Positron-emission tomography; Ultrasonography.

Publication types

  • Review

MeSH terms

  • Carcinoma, Pancreatic Ductal / diagnosis*
  • Carcinoma, Pancreatic Ductal / mortality
  • Carcinoma, Pancreatic Ductal / therapy
  • Critical Pathways
  • Diagnostic Imaging / methods*
  • Endoscopic Ultrasound-Guided Fine Needle Aspiration
  • Humans
  • Magnetic Resonance Imaging
  • Multimodal Imaging
  • Neoplasm Staging
  • Pancreatic Neoplasms / diagnosis*
  • Pancreatic Neoplasms / mortality
  • Pancreatic Neoplasms / therapy
  • Positron-Emission Tomography
  • Predictive Value of Tests
  • Tomography, X-Ray Computed