Identifying contraindications to resection in patients with pancreatic carcinoma: DETERMINATION OF RESECTABILITY Part 3

Pancreatic carcinomaStudies comparing helical CT with EUS yield conflicting results. EUS is clearly the most sensitive technique for the detection of pancreatic masses, particularly when they are smaller than 3 cm in diameter. The accuracy of EUS for local and regional tumour staging is similar among different series, ranging from 80% to 90%, whereas the accuracy of helical CT ranges from 56% to 90%. In a few series, the performance of helical CT has reached the level of EUS, which may reflect a transition toward more sophisticated scanning techniques. EUS and helical CT appear to have the same accuracy for diagnosing mesenteric venous invasion, but EUS is less accurate for diagnosing superior mesenteric artery invasion. In this sense, EUS should be considered for patients in whom a mass has not been identified or in whom CT results are equivocal for the presence of locally advanced disease (eg, vascular invasion). Additionally, EUS FNA of the mass and lymph nodes allows tissue diagnosis. Online shopping will cost you less – find cialis professional and enjoy the experience.

The role of MRI in the evaluation of patients with pancreatic adenocarcinoma is still evolving. In a multicentre study, dynamic thin-section CT had an accuracy (70%) similar to that of MRI in predicting the resectability of pancreatic adenocarcinoma. Faster helical CT scanners and higher Tesla strength MRI units with various imaging sequences and contrast agents are now providing even better performance characteristics. A recent study demonstrated improvements in the accuracy of both CT (81%) and MRI (96%) scans for predicting resectability. Further comparative studies are awaited to confirm these results. Arslan et al prospectively compared MRI, MRI angiography and dual-phase helical CT for the evaluation of vascular invasion in 31 patients with pancreatic carcinoma (including nine with vascular invasion). The diagnostic accuracies of the tests were 87%, 90% and 90%, respectively.


Category: Pancreatic carcinoma

Tags: Biopsy, Computed tomography, Endosonography, Pancreas adenocarcinoma, Pancreas neoplasm

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