CT in the differentiation of pancreatic neoplasms--progress report

Today, computed tomography (CT) is the most commonly used imaging method in the assessment of pancreatic tumors. The sensitivity of CT in detection of pancreatic tumors is more than 90% when direct and indirect signs are used for diagnosis. However, the potential to differentiate exocrine (non-endocrine) tumors of the pancreas is limited. CT is used in these lesions to perform an adequate staging, especially for surgical purposes. The operative resectability, primarily in regard to vessels, lymph node metastasis and hepatic metastasis, has to be assessed. Keeping in mind the limitations of this macromorphological imaging procedure, CT has the best reproducibility and overall accuracy of all imaging methods. Using multislice CT it is possible to perform non-axial reconstructions with high resolution. In functional endocrine tumors, multislice spiral CT will enhance the diagnostic capabilities, since the whole organ can be examined in thin slices, with high resolution during the rather short arterial phase of the contrast medium. Since some endocrine tumors are hypovascular, a scan during the portovenous phase is recommended too. The diagnosis of benign pancreatic tumors, like serous cystadenoma and pancreatic lipomas, is addressed. The most important pseudotumors of the pancreas are discussed.