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Duodenal invasion by pancreatic adenocarcinoma: MDCT diagnosis of an aggressive imaging phenotype and its clinical implications

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Abstract

Despite advances in oncologic and imaging technology, pancreatic ductal adenocarcinoma remains a highly deadly disease. The only curative option, pancreaticoduodenectomy or pancreatectomy, carries a significant morbidity. Current imaging plays a role in pre-operative staging to determine the probability of achieve disease-free margins. However, a small but not insignificant number of pancreatic cancers have a relatively higher aggressive biology, despite being resectable based on traditional criteria. Recently, imaging biomarkers that serve as a surrogate for tumors with such aggressive phenotype have been described. These include duodenal invasion and extrapancreatic perineural invasion. This review will focus on the former highlighting the summary of literature supporting duodenal invasion as a surrogate for aggressive disease as well as review its MDCT imaging features.

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Authors and Affiliations

  1. Department of Radiology, Duke University Medical Center, Erwin Rd, Box 3808, Durham, NC, 27710, USA

    Bhavik N. Patel

  2. Department of Radiology, Stanford University School of Medicine, 300 Pasteur Dr., H1307, Stanford, CA, 94305, USA

    Bhavik N. Patel, Eric W. Olcott & R. Brooke Jeffrey

  3. Department of Radiology, Veterans Affairs Palo Alto Health Care System, Palo Alto, 94304, CA, USA

    Eric W. Olcott

Authors
  1. Bhavik N. Patel
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  2. Eric W. Olcott
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  3. R. Brooke Jeffrey
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Correspondence to R. Brooke Jeffrey.

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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. Bhavik N. Patel 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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Patel, B.N., Olcott, E.W. & Jeffrey, R.B. Duodenal invasion by pancreatic adenocarcinoma: MDCT diagnosis of an aggressive imaging phenotype and its clinical implications. Abdom Radiol 43, 332–339 (2018). https://doi.org/10.1007/s00261-017-1271-8

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  • DOI: https://doi.org/10.1007/s00261-017-1271-8

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