Pancreatic cancer: Current concepts in imaging for diagnosis and staging

Because of its late clinical presentation. pancreatic cancer remains the fo urth most common cause of cancer death. Surgery is the only option for cure , and advancements in surgical technique and neoadjuvant therapy have the p otential to increase the number of patients who could undergo surgery for p otential cure. Accurate diagnosis and staging of pancreatic ductal carcinom a are therefore of great importance. This paper reviews the state of the ar t for such diagnostic modalities as computed tomography, magnetic resonance imaging, endoscopic ultrasound, positron emission tomography, and laparosc opic surgery and laparoscopic ultrasound for diagnosis and staging of pancr eatic cancer. Currently, accurate diagnosis and staging probably require th e use of a combination of techniques, including multiphase helical or multi detector computed tomography and/or dynamically enhanced magnetic resonance imaging with endoscopic ultrasound with fine-needle aspiration, The role o f positron emission tomography still needs to be determined. The role of la paroscopic surgery and laparoscopic ultrasound may be limited in those inst itutions with state-of-the-art imaging techniques.