Which imaging modality is best for detecting and staging pancreatic cancer?
- MDCT obtained in the pancreatic parenchymal phase with MPRs is the best imaging modality for detecting lesions as small as 2-3 mm and providing a detailed evaluation of the pancreatic duct.
- MDCT is better than US at evaluating adjacent spread or nodal involvement.
- Overlying bowel gas may limit evaluation of the pancreas with US; however, if the pancreas can be completely imaged with US, carcinoma can reliably be excluded.
- More recently, dual-energy CT obtained with a lower tube voltage (kVp) has been shown to increase detection of adenocarcinoma.
- Dynamic MRI with gadolinium can be performed in patients with iodine contrast allergy.
