Published in:
01-07-2009 | ORIGINAL ARTICLE – CONSENSUS REPORT: RESECTABLE AND BORDERLINE RESECTABLE PANCREAS CANCER
Pretreatment Assessment of Resectable and Borderline Resectable Pancreatic Cancer: Expert Consensus Statement
Authors:
Mark P. Callery, MD, Kenneth J. Chang, MD, Elliot K. Fishman, MD, Mark S. Talamonti, MD, L. William Traverso, MD, David C. Linehan, MD
Published in:
Annals of Surgical Oncology
|
Issue 7/2009
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Excerpt
Currently, multidetector computed tomography (CT) with three-dimensional (3-D) reconstruction is the preferred method to diagnose and stage pancreatic cancer. Magnetic resonance imaging and magnetic resonance imaging cholangiopancreatography can also detect primary tumors (hypointense on T1-weighted image) as well as regional and distant metastasis, but no clear advantage over CT has been demonstrated.
1 Magnetic resonance imaging cholangiopancreatography allows for visualization of the bile duct and pancreatic duct similar to endoscopic retrograde cholangiopancreatography (ERCP) but adds little to the assessment of resectability. The routine use of ERCP for diagnosis is not supported, but therapeutic ERCP may be considered in symptomatic patients with obstructive jaundice (e.g., moderate to severe pruritus) who are awaiting surgery. Endoscopic ultrasound (EUS) may be more sensitive than CT in detecting small tumors and can be useful in patients with obstructive jaundice and no mass or an atypical/questionable mass seen on CT. Its usefulness (especially in obtaining a pretreatment tissue diagnosis when warranted) is addressed later in the manuscript. …