What is the best imaging study with which to evaluate the pancreas?

FAQ Library published on August 6, 2013 in Assess & Monitor
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Margaret A. Tempero, MD
Professor of Medicine
Department of Medicine
Division of Hematology and Oncology
UCSF Helen Diller Family Comprehensive Cancer Center
San Francisco, California

What is the best imaging study with which to evaluate the pancreas?
Hi, I am Margaret Tempero. I am director of the Pancreas Center at the University of California, San Francisco. I am often asked about the best imaging study with which to evaluate the pancreas. It is not an easy question to answer and it really depends on what your goal is. If you are trying to screen a patient who might be at risk for pancreatic cancer because of a positive family history, you would want to use something that you can use repetitively without exposing the patient to radiation, so that might be endoscopic ultrasound or magnetic resonance cholangiopancreatography (MRCP). If you really think the patient has a pancreatic cancer because of presenting signs and symptoms, you need to order a pancreas protocol CT scan. This is a specialized scan with dynamic contrast where the pancreas is examined during both the arterial and venous phases. Duct duodenal carcinomas of the pancreas are sort of hypovascular and so they tend to be less dense. But neuroendocrine tumors of the pancreas are hypervascular and so they tend to take up the contrast and are best seen on the arterial phase, these are more dense.
Last modified: August 5, 2013
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