Imaging preoperatively for pancreatic adenocarcinoma

Area of Science:

• Oncology
• Radiology
• Surgical Oncology

Background:

• Pancreatic cancer is a lethal malignancy with increasing incidence and mortality.
• Current 5-year survival rates are low (6%), largely due to late diagnosis at advanced stages.
• Complete surgical resection is the only potentially curative treatment, but is only beneficial for resectable tumors.

Purpose of the Study:

• To highlight the critical role of cross-sectional imaging in the diagnosis and staging of pancreatic cancer.
• To emphasize the importance of accurate staging for determining surgical resectability and optimizing patient management.
• To discuss the utility of various imaging modalities in evaluating pancreatic adenocarcinoma.

Main Methods:

• Review of current diagnostic and staging modalities for pancreatic cancer.
• Discussion of Multi-detector computed tomography (MDCT) as the primary imaging tool.
• Evaluation of Magnetic Resonance Imaging (MRI) and Endoscopic Ultrasound (EUS) for lesion detection and staging.

Main Results:

• MDCT is the best-validated modality for pancreatic cancer diagnosis and staging.
• Contrast-enhanced MRI is equivalent to MDCT for detection and staging.
• EUS is sensitive for mass detection but limited for abdominal staging; often used adjunctively with MDCT.

Conclusions:

• Accurate preoperative imaging is essential to classify pancreatic tumors into resectable, borderline resectable, locally advanced, or metastatic categories.
• Standardized reporting templates improve the evaluation and surgical planning for pancreatic ductal adenocarcinoma.
• Structured reporting enhances surgeon confidence in assessing tumor resectability and impacts patient prognosis.