Skip to main content
SpringerLink
Log in
Book cover

Multislice CT pp 407–422Cite as

MDCT of Pancreatic Tumors

  • Chapter

Part of the book series: Medical Radiology ((Med Radiol Diagn Imaging))

Abstract

Dual-phasic contrast-enhanced MDCT in the pancreatic parenchymal and the venous phase is the method of choice for detection and staging of pancreatic cancer. Three-dimensional reconstructions (CPR, MIP, or VRT) are of great value for demonstration of tumors and the anatomical relationship between tumor and peripancreatic for the surgeon. For cystic lesion characterization, MDCT is comparable to MRI with MRCP, although MRI will increase the diagnostic confidence. For detection of small, hypervascular neuroendocrine tumors, no single imaging method will reveal all tumors. In this respect, MDCT and MRI are complementary methods.

This is a preview of subscription content, log in via an institution.

Chapter
USD   29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD   169.00
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
Hardcover Book
USD   219.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Learn about institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  • Alexakis N, Halloran C, Raraty M, Ghaneh P, Sutton R, Neoptolemos JP (2004) Current standards of surgery for pancreatic cancer. Br J Surg 91:1410–1427

    Article  PubMed  CAS  Google Scholar 

  • Bluemke DA, Cameron JL, Hruban RH et al. (1995) Potentially resectable pancreatic adenocarcinoma: spiral CT assessment with surgical and pathologic correlation. Radiology 197:381–385

    PubMed  CAS  Google Scholar 

  • Boland GW, O’Malley ME, Saez M, Fernandez-del Castillo C, Warshaw AL, Mueller PR (1999) Pancreatic-phase versus portal vein-phase helical CT of the pancreas: optimal temporal window for evaluation of pancreatic adenocarcinoma. AJR Am J Roentgenol 172:605–608

    PubMed  CAS  Google Scholar 

  • Bronstein YL, Loyer EM, Kaur H et al. (2004) Detection of small pancreatic tumors with multiphasic helical CT. AJR Am J Roentgenol 182:619–623

    PubMed  Google Scholar 

  • Brugge WR, Lewandrowski KB, Lee-Lewandrowski E et al. (2004) Diagnosis of pancreatic cystic neoplasms: a report of the cooperative study group. Gastroenterology 126:1330–1336

    Article  PubMed  Google Scholar 

  • DeWitt J, Deveraux B, Chriswell M et al. (2004) Comparison of endoscopic ultrasonography and multidetector computed tomography for detecting and staging pancreatic cancer. Ann Intern Med 141:753–763

    PubMed  Google Scholar 

  • Fernandez-del Castillo C, Targarona J, Thayer SP, Rattner DW, Brugge WR, Warshaw AL (2003) Incidental pancreatic cysts: clinicopathologic characteristics and comparison with symptomatic patients. Arch Surg 138:427–423; discussion, 433–424

    Google Scholar 

  • Fidler JL, Fletcher JG, Reading CC et al. (2003) Preoperative detection of pancreatic insulinomas on multiphasic helical CT. AJR Am J Roentgenol 181:775–780

    PubMed  CAS  Google Scholar 

  • Fletcher JG, Wiersma MJ, Farrell MA et al. (2003) Pancreatic malignancy: value of arterial, pancreatic, and hepatic phase imaging with multi-detector row CT. Radiology 229:81–90

    Article  PubMed  Google Scholar 

  • Freeny PC (2005) CT diagnosis and staging of pancreatic carcinoma. Eur Radiol 15(Suppl.):D96–D99

    PubMed  Google Scholar 

  • Fukukura Y, Fujiyoshi F, Sasaki M, Inoue H, Yonezawa S, Nakajo M (2000) Intraductal papillary mucinous tumors of the pancreas: thin-section helical CT findings. AJR Am J Roentgenol 174:441–447

    PubMed  CAS  Google Scholar 

  • Fukushima H, Itoh S, Takada A et al. (2006) Diagnostic value of curved multiplanar reformatted images in multislice CT for the detection of resectable pancreatic ductal adenocarcinoma. Eur Radiol 16:1709–1718

    Article  PubMed  Google Scholar 

  • Goshima S, Kanematsu M, Kondo H et al. (2006) Pancreas: optimal scan delay for contrast-enhanced multi-detector row CT. Radiology 241:167–174

    Article  PubMed  Google Scholar 

  • Gouya H, Vignaux O, Augui J et al. (2003) CT, endoscopic sonography, and a combined protocol for preoperative evaluation of pancreatic insulinomas. AJR Am J Roentgenol 181:987–992

    PubMed  Google Scholar 

  • Graf O, Boland GW, Warshaw AL, Fernandez-del Castillo C, Hahn PF, Mueller PR (1997) Arterial versus portal venous helical CT for revealing pancreatic adenocarcinoma: conspicuity of tumor and critical vascular anatomy. AJR Am J Roentgenol 169:119–123

    PubMed  CAS  Google Scholar 

  • Grenacher L, Klauss M, Dukic L et al. (2004) Hochauflösende Bildgebung beim Pankreaskarzinom: prospektiver Vergleich von MRT und 4-Zeilen-Spiral-CT. Fortschr Rontgenstr 176:1624–1633 (in German)

    Article  CAS  Google Scholar 

  • Hough TJ, Raptopoulos V, Siewert B, Matthews JB (1999) Teardrop superior mesenteric vein: CT sign for unresectable carcinoma of the pancreas. AJR Am J Roentgenol 173:1509–1512

    PubMed  CAS  Google Scholar 

  • Ichikawa T, Haradome H, Hachiya J et al. (1997) Pancreatic ductal adenocarcinoma: preoperative assessment with helical CT versus dynamic MR imaging. Radiology 202:655–662

    PubMed  CAS  Google Scholar 

  • Irie H, Honda H, Kaneko K, Kuroiwa T, Yoshimitsu K, Masuda K (1997) Comparison of helical CT and MR imaging in detecting and staging small pancreatic adenocarcinoma. Abdom Imaging 22:429–433

    Article  PubMed  CAS  Google Scholar 

  • Irie H, Yoshimitsu K, Aibe H et al. (2004) Natural history of pancreatic intraductal papillary mucinous tumor of branch duct type: follow-up study by magnetic resonance cholangiopancreatography. J Comput Assist Tomogr 28:117–122

    Article  PubMed  Google Scholar 

  • Klapman JB, Chang KJ, Lee JG, Nguyen P (2005) Negative predictive value of endoscopic ultrasound in a large series of patients with a clinical suspicion of pancreatic cancer. Am J Gastroenterol 100:2658–2661

    Article  PubMed  Google Scholar 

  • Legmann P, Vignaux O, Dousset B et al. (1998) Pancreatic tumors: comparison of dual-phase helical CT and endoscopic sonography. AJR Am J Roentgenol 170:1315–1322

    PubMed  CAS  Google Scholar 

  • Lowenfels AB, Maisonneuve PM, Cavallini G et al. (1993) Pancreatitis and the risk of pancreatic cancer. New Engl J Med 328:1435–1437

    Article  Google Scholar 

  • Lowenfels AB, Maisonneuve P, DiMagno EP et al. (1997) Hereditary pancreatitis and the risk of pancreatic cancer. International Hereditary Pancreatitis Study Group. J Natl Cancer Inst 89:442–446

    Article  PubMed  CAS  Google Scholar 

  • Lu DSK, Vedantham S, Krasny RM, Kadell B, Berger WL, Reber HA (1996) Two-phase helical CT for pancreatic tumors: pancreatic versus hepatic phase enhancement of tumor, pancreas, and vascular structures. Radiology 199:697–701

    PubMed  CAS  Google Scholar 

  • Lu DSK, Reber HA, Krasny RM, Kadell BM, Sayre J (1997) Local staging of pancreatic cancer: criteria for unresectability of major vessels as revealed by pancreatic-phase thin section helical CT. AJR Am J Roentgenol 168:1439–1443

    PubMed  CAS  Google Scholar 

  • McNulty NJ, Francis IR, Platt JF, Cohan RH, Korobkin M, Gebramaniam A (2001) Multi-detector row helical CT of the pancreas: effect of contrast-enhanced multiphasic imaging on enhancement of the pancreas, peripancreatic vasculature, and pancreatic adenocarcinoma. Radiology 220:97–102

    PubMed  CAS  Google Scholar 

  • Merkle EM, Boaz T, Kolokythas O, Haaga JR, Lewin JS, Brambs H-J (1998) Metastases to the pancreas. Br J Radiol 71:1208–1214

    PubMed  CAS  Google Scholar 

  • Morana G, Guarise A (2006) Cystic tumors of the pancreas. Cancer Imaging 6:60–71

    Article  PubMed  Google Scholar 

  • Nakayama Y, Yamashita Y, Kadota M et al. (2001) Vascular encasement by pancreatic cancer: correlation of CT findings with surgical and pathologic results. J Comput Assist Tomogr 25:337–342

    Article  PubMed  CAS  Google Scholar 

  • Ng CS, Loyer EM, Iyer RB, David CL, DuBrow RA, Charnsangavej C (1999) Metastases to the pancreas from renal cell carcinoma: findings on three-phase contrast-enhanced helical CT. AJR Am J Roentgenol 172:1555–1559

    PubMed  CAS  Google Scholar 

  • Noone TC, Hosey J, Firat Z, Semelka RC (2005) Imaging and localization of islet-cell tumours of the pancreas on CT and MRI. Best Pract Res Clin Endocrinol Metab 19:195–211

    Article  PubMed  Google Scholar 

  • Procacci C, Megibow AJ, Carbognin G et al. (1999) Intraductal papillary mucinous tumor of the pancreas: a pictorial essay. Radiographics 19:1447–1463

    PubMed  CAS  Google Scholar 

  • Procacci C, Carbognin G, Biasiutti C, Guarise A, Ghirardi C, Schenal G (2001) Intraductal papillary mucinous tumors of the pancreas: spectrum of CT and MR findings with pathologic correlation. Eur Radiol 11:1939–1951

    Article  PubMed  CAS  Google Scholar 

  • Prokesch R, Chow LC, Beaulieu CF, Bammer R, Jeffrey RB (2002) Isoattenuating pancreatic carcinoma at multi-detector row CT: secondary signs. Radiology 224:764–768

    Article  PubMed  Google Scholar 

  • Prokesch RW, Chow LC, Beaulieu CF et al. (2002) Local staging of pancreatic carcinoma with multi-detector row CT: use of curved planar reformations-initial experience. Radiology 225:759–765

    Article  PubMed  Google Scholar 

  • Rappeport ED, Hansen CP, Kjaer A, Knigge U (2006) Multidetector computed tomography and neuroendocrine pancreaticoduodenal tumors. Acta Radiol 47:248–256

    Article  PubMed  CAS  Google Scholar 

  • Rha SE, Jung SE, Lee KL, Ku YM, Byun JY, Lee JM (2007) CT and MR imaging findings of endocrine tumor according to WHO classification. Eur J Radiol 62:371–377

    Article  PubMed  Google Scholar 

  • Richter GM, Wunsch C, Schneider B et al. (1998) Hydro-CT in der Detektion und im Staging des Pankreaskarzinoms. Radiologe 38:279–286 (in German)

    Article  PubMed  CAS  Google Scholar 

  • Sahani DV, Kadavigere R, Saokar A, Fernandez-del Castillo C, Brugge WR, Hahn PF (2005) Cystic pancreatic lesions: a simple imaging-based classification system for guiding management. Radiographics 25:1471–1484

    Article  PubMed  Google Scholar 

  • Sahani DV, Kadavigere R, Blake M, Fernandez-Del Castillo C, Lauwers GY, Hahn PF (2006a) Intraductal papillary mucinous neoplasm of pancreas: multi-detector row CT with 2D curved reformations–correlation with MRCP. Radiology 238:560–569

    Article  Google Scholar 

  • Sahani DV, Saokar A, Hahn PF, Brugge WR, Fernandez-del Castillo C (2006b) Pancreatic cysts 3 cm or smaller: how aggressive should treatment be? Radiology 238:912–919

    Article  Google Scholar 

  • Schima W, Ba-Ssalamah A, Kolblinger C, Kulinna-Cosentini C, Puespoek A, Gotzinger P (2007) Pancreatic adenocarcinoma. Eur Radiol 17:638–649

    Article  PubMed  Google Scholar 

  • Schima W, Függer R, Schober E et al. (2002) Diagnosis and staging of pancreatic cancer: comparison of mangafodipir-enhanced MRI and contrast-enhanced helical hydro-CT. AJR Am J Roentgenol 179:717–724

    PubMed  Google Scholar 

  • Schima W, Ba-Ssalamah A, Plank C et al. (2006) [Pancreas. Part II: tumors.]. Radiologe 46:421–437

    Article  PubMed  CAS  Google Scholar 

  • Schueller G, Schima W, Schueller-Weidekamm C et al. (2006) Multidetector CT of pancreas: effects of contrast material flow rate and individualized scan delay on enhancement of pancreas and tumor contrast. Radiology 241:441–448

    Article  PubMed  Google Scholar 

  • Stankard CE, Karl RC (1992) The treatment of isolated pancreatic metastases from renal cell carcinoma: a surgical review. Am J Gastroenterol 87:1658–1660

    PubMed  CAS  Google Scholar 

  • Tanaka M, Chari S, Adsay V et al. (2006) International consensus guidelines for management of intraductal papillary mucinous neoplasms and mucinous cystic neoplasms of the pancreas. Pancreatology 6:17–32

    Article  PubMed  Google Scholar 

  • Taouli B, Vilgrain V, Vullierme M-P et al. (2000) Intraductal papillary tumors of the pancreas: helical CT with histopathologic correlation. Radiology 217:757–764

    PubMed  CAS  Google Scholar 

  • Trede M, Schwall G, Saeger H-D (1990) Survival after pancreatoduodenectomy. 118 consecutive resections without an operative mortality. Ann Surg 211:447–458

    Article  PubMed  CAS  Google Scholar 

  • Tseng JF, Warshaw AL, Sahani DV, Lauwers GY, Rattner DW, Fernandez-del Castillo C (2005) Serous cystadenoma of the pancreas: tumor growth rates and recommendations for treatment. Ann Surg 242:413–419

    PubMed  Google Scholar 

  • Tublin ME, Tessler FN, Cheng SL, Peters TL, McGovern PC (1999) Effect of injection rate of contrast medium on pancreatic and hepatic helical CT. Radiology 210:97–101

    PubMed  CAS  Google Scholar 

  • Vargas R, Nino-Murcia M, Trueblood W, Jeffrey RBJ (2004) MDCT in pancreatic adenocarcinoma: prediction of vascular invasion and resectability using a multiphasic technique with curved planar reformations. AJR Am J Roentgenol 182:419–245

    PubMed  Google Scholar 

  • Visser BC, Yeh BM, Qayyum A, Way LW, McCulloch CE, Coakley FV (2007) Characterization of cystic pancreatic masses: relative accuracy of CT and MRI. AJR Am J Roentgenol 189:648–656

    Article  PubMed  Google Scholar 

  • Warshaw AL, Fernandez-del Castillo C (1992) Pancreatic carcinoma. N Engl J Med 326:455–465

    PubMed  CAS  Google Scholar 

  • Yamada Y, Mori H, Kiyosue H, Matsumoto S, Hori Y, Maeda T (2000) CT assessment of the inferior peripancreatic veins: clinical significance. AJR Am J Roentgenol 174:677–684

    PubMed  CAS  Google Scholar 

  • Yanaga Y, Awai K, Nakayama Y et al. (2007) Pancreas: patient body weight tailored contrast material injection protocol versus fixed dose protocol at dynamic CT. Radiology 245:475–482

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Abteilung für Radiologie und bildgebende Diagnostik, KH Göttlicher Heiland, Dornbacher Strasse 20–28, 1170, Vienna, Austria

    Wolfgang Schima

  2. Universitätsklinik für Radiodiagnostik, Medizinische Universität Wien, Währinger Gürtel 18–20, 1090, Wien, Austria

    Claus Kölblinger & Ahmed Ba-Ssalamah

Authors
  1. Wolfgang Schima
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Claus Kölblinger
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Ahmed Ba-Ssalamah
    View author publications

    You can also search for this author in PubMed Google Scholar

Editor information

Editors and Affiliations

  1. Munich University Hospital, Institute of Clinical Radiology, Ludwig-Maximilians University, Marchioninistr. 15, 81377, Munich, Germany

    Maximilian F. Reiser , C.R. Becker  & Konstantin Nikolaou ,  & 

  2. School of Medicine, Department of Radiology, Stanford University, 1201 Welch Road, 94304, Palo Alto, CA, USA

    Gary Glazer

Rights and permissions

Reprints and permissions

Copyright information

© 2009 Springer-Verlag Berlin Heidelberg

About this chapter

Cite this chapter

Schima, W., Kölblinger, C., Ba-Ssalamah, A. (2009). MDCT of Pancreatic Tumors. In: Reiser, M., Becker, C., Nikolaou, K., Glazer, G. (eds) Multislice CT. Medical Radiology. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-540-33125-4_30

Download citation

  • DOI: https://doi.org/10.1007/978-3-540-33125-4_30

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-540-33124-7

  • Online ISBN: 978-3-540-33125-4

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation