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Radiologic Techniques for Diagnosis and Staging of Pancreatic Carcinoma

  • Mark E. Baker

Abstract

The purpose of imaging patients with pancreatic carcinoma is to detect the primary tumor, to determine whether the tumor is potentially resectable or unresectable, and, lastly, to guide a confirmatory percutaneous biopsy.

Keywords

Pancreatic Cancer Pancreatic Carcinoma Pancreatic Adenocarcinoma Obstructive Jaundice Percutaneous Biopsy 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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References

  1. 1.
    Arvan DA. Obstructive jaundice. In: Panzer RJ, Black BR, and Griner PF (eds). Diagnostic strategies for common medical problems. American College of Physicians, Philadelphia, 1991;pp. 131–140.Google Scholar
  2. 2.
    Frank BB. Clinical evaluation of jaundice: a guideline of the patient care committee of the American Gastroenterological Association. JAMA 1989; 262:3031–3034.PubMedCrossRefGoogle Scholar
  3. 3.
    Heiken JP, Brink JA, and Vannier MW. Spiral (helical) CT. Radiology 1993; 189:647–656.PubMedGoogle Scholar
  4. 4.
    Johnson PT, Heath DG, Bliss DF, Cabrai B, and Fishman EK. Three-dimensional CT: realtime interactive volume rendering. AJR 1996; 167:581–583.PubMedGoogle Scholar
  5. 5.
    Freeny PC, Marks WM, Ryan JA, and Traverso LW. Pancreatic ductal adenocarcinoma: diagnosis and staging with dynamic CT. Radiology 1988; 166:125–133.PubMedGoogle Scholar
  6. 6.
    Freeny PC, Traverso LW, and Ryan JA. Diagnosis and staging of pancreatic adenocarcinoma with dynamic computed tomography. Am J Surg 1993; 165:600–606.PubMedCrossRefGoogle Scholar
  7. 7.
    Megibow AJ, Zhou XH, Rotterdam H, Francis IR, Zerhouni EZ, Balfe DM, et al. Pancreatic adenocarcinoma: CT versus MR imaging in the evaluation of resectability-report of the radiology diagnostic oncology group. Radiology 1995; 195:327–332.PubMedGoogle Scholar
  8. 8.
    Gulliver DJ, Baker ME, Cheng CA, Meyers WC, and Pappas TN. Malignant biliary obstruction: efficacy of thin-section dynamic CT in determining resectability. AJR 1992; 159:503–507.PubMedGoogle Scholar
  9. 9.
    Megibow AJ. Pancreatic adenocarcinoma: designing the examination to evaluate the clinical questions. Radiology 1992; 183:297–303.PubMedGoogle Scholar
  10. 10.
    Spiessl B, Beahrs OH, Hermanek P, Hutter RVP, TNM atlas: illustrated guide to the TNM/p TNM classification of malignant tumors, 3rd edx., 2nd revision, Scheibe, Sobin LH, Wagner G (eds). Springer-Verlag, Berlin, 1992, pp. 132–139.Google Scholar
  11. 11.
    Yeo CJ, Cameron JL, and Lillemore KD. Pancreaticoduodenectomy for cancer of the head of the pancreas: 201 patients. Ann Surg 1995; 221:721–733.PubMedCrossRefGoogle Scholar
  12. 12.
    Loyer EM, David CL, Dubrow RA, Evans DB, and Charnsangevej C. Vascular involvement in pancreatic adenocarcinoma: reassessment by thin-section CT. Abdom Imaging 1996; 21:202–206.PubMedCrossRefGoogle Scholar
  13. 13.
    Fuhrman GM, Charnsangavej C, Abbruzzese JL, Cleary KR, Martin RG, Fenoglio CJ, and Evans DB. Thin-section contrast enhanced computed tomography accurately predicts the resectability of malignant pancreatic neoplasms. Am J Surg 1994; 167:104–113.PubMedCrossRefGoogle Scholar
  14. 14.
    Warshaw A and Fernandez-Del Castillo C. Pancreatic carcinoma. N Engl J Med 1992; 326:455–465.PubMedCrossRefGoogle Scholar
  15. 15.
    Warshaw AL. Implications of peritoneal cytology for staging of early pancreatic cancer. Am J Surg 1991; 161:26–30.PubMedCrossRefGoogle Scholar
  16. 16.
    Megibow AJ, Bosniak MA, Ambos MA, and Beranbaum ER. Thickening of the celiac axis and/or superior mesenteric artery: a sign of pancreatic carcinoma on computed tomography. Radiology 1981; 141:449–453.PubMedGoogle Scholar
  17. 17.
    Baker ME, Cohan RH, Nadel SN, Leder RA, and Dunnick NR. Obliteration of the fat surrounding the celiac axis and superior mesenteric artery is not a specific CT finding of carcinoma of the pancreas. AJR 1990; 155:991–994.PubMedGoogle Scholar
  18. 18.
    Baker ME. Pancreatic adenocarcinoma: Are there pathognomonic changes in the fat surrounding the superior mesenteric artery? Radiology 1991; 180:613–614.PubMedGoogle Scholar
  19. 19.
    Bluemke D, Cameron JI, Hruban R, Pitt H, Siegelman SS, Soyer P, and Fishman E. Potentially resectable pancreatic adenocarcinoma: spiral CT assessment with surgical and pathologic correlation. Radiology 1995; 197:381–385.PubMedGoogle Scholar
  20. 20.
    Mackie CR, Lu CT, Noble HG, Cooper MB, Collins P, Block GE, and Moossa AR. Prospective evaluation of angiography in the diagnosis and management of patients suspected of having pancreatic cancer. Ann Surg 1979; 189:11–17.PubMedCrossRefGoogle Scholar
  21. 21.
    Jafri SZ, Aisen AM, Glazer GM, and Weiss CA. Comparison of CT and angiography in assessing resectability of pancreatic carcinoma. AJR 1984; 142:525–529.PubMedGoogle Scholar
  22. 22.
    Rong GH and Sindelar WF. Aberrant peripancreatic arterial anatomy: considerations of performing pancreatectomy for malignant neoplasms. Am Surg 1987; 53:726–729.PubMedGoogle Scholar
  23. 23.
    Warshaw AL, Gu Z, Wittenberg J, and Waltman AC. Preoperative staging and assessment of resectability of pancreatic cancer. Arch Surg 1990; 125:230–233.PubMedCrossRefGoogle Scholar
  24. 24.
    Dooley WC, Cameron JL, Pitt HA, Lillemoe KD, Yue NC, and Venbrux AC. Is preoperative angiography useful in patients with periampullary tumors? Ann Surg 1990; 211:649–655.PubMedCrossRefGoogle Scholar
  25. 25.
    Murugiah M, Windsor JA, Redhead DN, O’Neill JS, Suc B, Garden OJ, and Carter DC. The role of selective visceral angiography in the management of pancreatic and periampullary cancer. World J Surg 1993; 17:796–800.PubMedCrossRefGoogle Scholar
  26. 26.
    Biehl TR, Traverso W, Hauptmann E, and Ryan JA. Preoperative visceral angiography alters intraoperative strategy during the whipple procedure. Am J Surg 1993; 165:607–612.PubMedCrossRefGoogle Scholar
  27. 27.
    Hommeyer SC, Freeny PC, and Crabo LG. Carcinoma of the head of the pancreas: Evaluation of the pancreaticoduodenal veins with dynamic CT-potential for improved accuracy in staging. Radiology 1995; 196:223–238.Google Scholar
  28. 28.
    Ward EM, Stephens DH, and Sheedy PF. Computed tomographic characteristics of pancreatic carcinoma: an analysis of 100 cases. RadioGraphics 1983; 3:547–565.Google Scholar
  29. 29.
    Lu DS, Vedantham S, Krasy RM, Kadell BM, Berger W, and Reber HA. Two-phase helical CT of pancreatic tumors: pancreatic versus hepatic phase enhancement of tumor, pancreas and vascular structures. Radiology 1996; 199:697–701.PubMedGoogle Scholar
  30. 30.
    Choi BI, Chung MJ, Han JK, and Han MC. Spiral CT in the evaluation of pancreatic adenocarcinoma: relative value of arterial-and portal venous-phase scanning. Radiology 1995; 197(P):245.Google Scholar
  31. 31.
    Fishman E, Wyatt SH, Ney DR, Kuhlman JE, and Siegelman SS. Spiral CT of the pancreas with multiplanar display. AJR 1992; 159:1209-1215.Google Scholar
  32. 32.
    Rubin GD, Dake MD, Napel SA, McDonnell CH, and Jeffrey RB. Three-dimensional spiral CT angiography of the abdomen: initial clinical experience. Radiology 1993; 186:147–152.PubMedGoogle Scholar
  33. 33.
    Winter TC, Freeny PC, Nghiem HV, Hommeyer SC, Barr D, Croghan AM, et al. Hepatic arterial anatomy in transplantation candidates: evaluation with three-dimensional CT arteriography. Radiology 1995; 195:363–370.PubMedGoogle Scholar
  34. 34.
    Cuesta MA, Meijer S, Borgstein PJ, Mulder LS, and Sikkenk AC. Laparoscopic ultra-sonography for hepatobiliary and pancreatic malignancy. Br J Surg 1993; 80:1571–1574.PubMedCrossRefGoogle Scholar
  35. 35.
    John TG, Greig JD, Crosbie JL, Miles WF, and Garden OJ. Superior staging of liver tumors with laparoscopy and laparoscopic ultrasound. Ann Surg 1994; 220:711–719.PubMedCrossRefGoogle Scholar
  36. 36.
    John TG, Greig JD, Carter DC, and Garden OJ. Carcinoma of the pancreatic head and periampullary region: tumor staging with laparoscopy and laparoscopic ultrasonography. Ann Surg 1995; 221:156–164.PubMedCrossRefGoogle Scholar
  37. 37.
    Alvarez C, Livingston EH, Ashley SW, Schwarz M, and Reber HA. Cost-benefit analysis of the work-up for pancreatic cancer. Am J Surg 1993; 166:53–60.CrossRefGoogle Scholar
  38. 38.
    Mitchell DG, Vinitski S, Saponaro S, Tasciyan T, Burk DL, and Rifkin MD. Liver and pancreas: improved spin-echo T1 contrast by shorter echo time and fat suppression at 1.5 T. Radiology 1991; 178:67–71.PubMedGoogle Scholar
  39. 39.
    Semelka RC, Kroeker MA, Shoenut JP, Kroeker R, Yaffe CS, and Micflikier AB. Pancreatic disease: Prospective comparison of CT, ERCP, and 1.5-T MR imaging with dynamic gadolinium enhancement and fat suppression. Radiology 1991; 181:785–791.PubMedGoogle Scholar
  40. 40.
    Vellet AD, Romano W, Bach DB, Passi RB, Taves DH, and Munk PL. Adenocarcinoma of the pancreatic ducts: comparative evaluation with CT and MR imaging of 1.5 T. Radiology 1992; 183:87–95.PubMedGoogle Scholar
  41. 41.
    Gehl HB, Vorwerk D, Klose KC, and Günther RW. Pancreatic enhancement after low-dose infusion of Mn-DPDP. Radiology 1991; 180:337–339.PubMedGoogle Scholar
  42. 42.
    Mitchell DG, Shapiro M, Schurict A, Barbot D, and Rosato FR. Pancreatic disease; findings of state-of-the-art MR images. AJR 1992; 159:533–538.PubMedGoogle Scholar
  43. 43.
    Semelka RC and Ascher SM. MR imaging of the pancreas. Radiology 1993; 188:593–602.PubMedGoogle Scholar
  44. 44.
    Gehl HB, Urhahn R, Bohndorf K, Klever P, Hauptmann S, Lodemann KP, et al. Mn-DPDP in MR imaging of pancreatic adenocarcinoma: initial clinical experience. Radiology 1993; 186:795–798.PubMedGoogle Scholar
  45. 45.
    Toshifumi G, Matsui O, Kadoya M, Yoshikawa J, Miyayama S, Takashima T, et al. Small pancreatic adenocarcinomas: efficacy of MR imaging with fat suppression and gadolinium enhancement. Radiology 1994; 193:683–688.Google Scholar
  46. 46.
    Megibow AJ, Zhou XH, Rotterdam H, Francis IR, Zerhouni EA, Balfe DM, et al. Pancreatic adenocaircinoma: CT versus MR imaging in the evaluation of resectability—report of the Radiology Diagnostic Oncology Group. Radiology 1995; 195:327–332.PubMedGoogle Scholar
  47. 47.
    McFarland EG, Kaufman JA, Saini S, Halpern EF, Lu DSK, Waltman AC, and Warshaw AL. Preoperative staging of cancer of the pancreas: value of MR angiography vs. conventional angiography in detecting portal venous invasion. AJR 1996; 166:37–43.PubMedGoogle Scholar
  48. 48.
    Campbell JP and Wilson SR. Pancreatic neoplasms: How useful is evaluation with US? Radiology 1988;167:341–344.PubMedGoogle Scholar
  49. 49.
    Bares R, Klever P, Hauptmann S, Hellwig D, Fass J, Cremerius U, et al. F-18 fluorodeoxyglucose PET in vivo evaluation of pancreatic glucose metabolism for detection of pancreatic cancer. Radiology 1994; 192:79–86.PubMedGoogle Scholar
  50. 50.
    Stollfuss JC, Glatting G, Friess H, Kocher F, a Beger HG, and Reske SN. 2-(fluorine-18)-fluoro-2-deoxy-D-glucose PET in detection of pancreatic cancer: value of quantitative image interpretation. Radiology 1995; 195:339–344.PubMedGoogle Scholar
  51. 51.
    Inokuma T, Tamaki N, Torizuka T, Magata Y, Fuji M, Yonekura Y, et al. Evaluation of pancreatic tumors with positron emission tomography and F-18 fluorodeoxyglucose: comparison with CT and US. Radiology 1995; 195:345–352.PubMedGoogle Scholar
  52. 52.
    Kocjan G, Rode J, and Lees WR. Percutaneous fine needle aspiration cytology of the pancreas: advantages and pitfalls. J Clin Pathol 1989; 42:341–347.PubMedCrossRefGoogle Scholar
  53. 53.
    Al-Kaisi N and Siegler EE. Fine needle aspiration cytology of the pancreas. Acta Cytol 1989; 33:145–152.PubMedGoogle Scholar
  54. 54.
    Athlin L, Blind PJ, and Ångstrom T. Fine-needle aspiration biopsy of pancreatic masses. Acta Chir Scand 1990; 156:91–94.PubMedGoogle Scholar
  55. 55.
    Parsons L and Palmer CH. How accurate is fine-needle biopsy in malignant neoplasia of the pancreas? Arch Surg 1989; 124:681–683.PubMedCrossRefGoogle Scholar
  56. 56.
    Brandt KR, Charboneau JW, Stephens DH, Welch TJ, and Goellner JR. CT and US guided biopsy of the pancreas. Radiology 1993; 187:99–104.Google Scholar
  57. 57.
    Ferrucci JT, Wittenberg J, Margolies MN, and Carey RW. Malignant seeding of the tract after thin-needle aspiration biopsy. Radiology 1979; 130:345–346.PubMedGoogle Scholar
  58. 58.
    Rashleigh-Belcher HJ, Russell RC, and Lees WR. Cutaneous seeding of pancreatic carcinoma by fine-needle aspiration biopsy. Brit J Radiol 1986; 59:183–185.CrossRefGoogle Scholar
  59. 59.
    Weiss SM, Skibber JM, Mohiuddin M, and Rosato FE. Rapid intra-abdominal spread of pancreatic cancer. Arch 1985; 120:415–416.Google Scholar
  60. 60.
    Balen FG, Little A, Smith AC, Theis BA, Abrams KR, Houghton J, et al. Biopsy of inoperable pancreatic tumors does not adversely influence patient survival time. Radiology 1994; 193:753–755.PubMedGoogle Scholar
  61. 61.
    Lillemoe K. Current management of pancreatic carcinoma. Ann Surg 1995; 221:133–148.PubMedCrossRefGoogle Scholar
  62. 62.
    Stephens DH. Pancreatic adenocarcinoma: editorial commentary. Abdom Imaging 1996; 21:207–210.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media New York 1998

Authors and Affiliations

  • Mark E. Baker

There are no affiliations available

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