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Diagnosis and staging of pancreatic cancer
Pancreatic cancer is one of the most lethal cancers, and continues to be a major health problem in the twenty-first century. Early-stage disease is usually clinically silent, or manifests with non-specific symptoms that often go unrecognised; therefore, diagnosis is invariably dependent on imaging methods. Although transabdominal ultrasound imaging (TAUS) is frequently the first-line diagnostic approach for patients presenting with jaundice and/or upper abdominal pain, computerized tomography (CT) is the most commonly used imaging method for the diagnosis and staging of pancreatic cancer. The more sensitive multiphase, multidetector helical CT constitutes the method of choice. In addition, magnetic resonance imaging (MRI) can also detect primary pancreatic tumours as well as regional and distant metastases, and, in recent years, positron emission tomography (PET) – stand-alone or in combination with CT – has been established as a useful adjunct. Recently, endoscopic ultrasonography (EUS) has gained popularity as a promising staging modality, and it currently has a complementary role to CT for the evaluation of patients with pancreatic cancer. Nevertheless, despite recent technologic advancements in the diagnostic approach to pancreatic cancer and the refinement of the clinical staging algorithm, early diagnosis remains challenging and a substantial improvement in patient outcomes has not yet been observed.
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