White paper on pancreatic ductal adenocarcinoma from society of abdominal radiology’s disease-focused panel for pancreatic ductal adenocarcinoma: Part II, update on imaging techniques and screening of pancreatic cancer in high-risk individuals

  • Naveen M. KulkarniEmail author
  • Lorenzo Mannelli
  • Marc Zins
  • Priya R. Bhosale
  • Hina Arif-Tiwari
  • Olga R. Brook
  • Elizabeth M. Hecht
  • Fay Kastrinos
  • Zhen Jane Wang
  • Erik V. Soloff
  • Parag P. Tolat
  • Guillermo Sangster
  • Jason Fleming
  • Eric P. Tamm
  • Avinash R. Kambadakone


Pancreatic ductal adenocarcinoma (PDAC) is an aggressive gastrointestinal malignancy with a poor 5-year survival rate. Its high mortality rate is attributed to its aggressive biology and frequently late presentation. While surgical resection remains the only potentially curative treatment, only 10–20% of patients will present with surgically resectable disease. Over the past several years, development of vascular bypass graft techniques and introduction of neoadjuvant treatment regimens have increased the number of patients who can undergo resection with a curative intent. While the role of conventional imaging in the detection, characterization, and staging of patients with PDAC is well established, its role in monitoring treatment response, particularly following neoadjuvant therapy remains challenging because of the complex anatomic and histological nature of PDAC. Novel morphologic and functional imaging techniques (such as DECT, DW-MRI, and PET/MRI) are being investigated to improve the diagnostic accuracy and the ability to measure response to therapy. There is also a growing interest to detect PDAC and its precursor lesions at an early stage in asymptomatic patients to increase the likelihood of achieving cure. This has led to the development of pancreatic cancer screening programs. This article will review recent updates in imaging techniques and the current status of screening and surveillance of individuals at a high risk of developing PDAC.


Pancreatic ductal adenocarcinoma DECT DW-MRI PET/MR Pancreatic cancer screening 



The authors wish to thank the members of Society of Abdominal Radiology’s Disease-Focused Panel for Pancreatic Cancer for their suggestions and input in selecting the topics for the white paper (Ajit Goenka, MD, Alexander Guimares MD, PhD, Arnold Friedman, MD, Atif Zaheer, MD, David Hough, MB, ChB, Michael Rosenthal, MD, PhD, Namita Gandhi, MD, Ott Le, MD, Richard Do, MD, PhD, Zarine Shah, MD). We also wish to acknowledge Olivier Lucidarme, MD (Paris) for assistance with Fig. 6.

Compliance with ethical standards

Conflict of interest

All the authors declared that they have no conflict of interest.


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© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  • Naveen M. Kulkarni
    • 1
    Email author
  • Lorenzo Mannelli
    • 2
  • Marc Zins
    • 3
  • Priya R. Bhosale
    • 4
  • Hina Arif-Tiwari
    • 5
  • Olga R. Brook
    • 6
  • Elizabeth M. Hecht
    • 7
  • Fay Kastrinos
    • 8
  • Zhen Jane Wang
    • 9
  • Erik V. Soloff
    • 10
  • Parag P. Tolat
    • 1
  • Guillermo Sangster
    • 11
  • Jason Fleming
    • 12
  • Eric P. Tamm
    • 4
  • Avinash R. Kambadakone
    • 13
  1. 1.Department of RadiologyMedical College of WisconsinMilwaukeeUSA
  2. 2.Diagnostic Medical ImagingIRCCS SDNNaplesItaly
  3. 3.Department of RadiologyGroupe Hospitalier Paris Saint-JosephParisFrance
  4. 4.Abdominal Imaging DepartmentThe University of Texas MD Anderson Cancer CenterHoustonUSA
  5. 5.Department of Medical ImagingUniversity of Arizona College of MedicineTucsonUSA
  6. 6.Department of RadiologyBeth Israel Deaconess Medical CenterBostonUSA
  7. 7.Department of RadiologyColumbia University Medical CenterNew YorkUSA
  8. 8.Division of Digestive and Liver Diseases, Department of MedicineColumbia University Medical CancerNew YorkUSA
  9. 9.Department of Radiology and Biomedical ImagingUniversity of California San FranciscoSan FranciscoUSA
  10. 10.Department of RadiologyUniversity of WashingtonSeattleUSA
  11. 11.Department of RadiologyOchsner LSU Health ShreveportShreveportUSA
  12. 12.Gastrointestinal OncologyMoffitt Cancer CenterTampaUSA
  13. 13.Department of RadiologyMassachusetts General HospitalBostonUSA

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