Pancreatic ductal adenocarcinoma continues to be a highly lethal disease, despite advances in modern medicine. Curative surgical options continue to carry significant morbidity and offer little improvement in overall 5-year survival. Currently, imaging plays an essential role in the pre-operative evaluation of patients who are undergoing evaluation for resection. However, some pancreatic cancers have particularly aggressive biology, despite appearing resectable by conventional imaging criteria. Imaging biomarkers that serve as surrogates for tumors with such aggressive phenotype have been recently described, namely duodenal invasion and extrapancreatic perineural invasion. In this pictorial review, we will summarize key concepts of extrapancreatic perineural invasion, describe its association with a poor prognosis, and highlight the role of imaging in its detection.
Pancreatic cancer adenocarcinoma perineural invasion pathways 3D volume rendering
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BNP—research support and consultant, GE Healthcare. EC—none. RBJ—none. Study Industry Support: none.
Compliance with ethical standards
This study did not involve human and animal subjects, and therefore an Institutional Review Board approval and informed consent were not required. The authors had control of the data and the information submitted for publication. [Blinded to reviewers] is a medical consultant and has received research support from GE Healthcare. All other authors are not employees of or consultants for industry and had control of inclusion of any data and information that might present a conflict of interest. There was no industry support specifically for this study.
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