Comparison of Pancreatic Ductal Adenocarcinoma Imaging Modalities
Updated: Jul 5, 2022
Pancreatic ductal adenocarcinoma (PDAC) is a fatal type of cancer with an increasing incidence rate in North America. The only curative procedure of this disease is the Whipple procedure, which is restricted only to those that received an early diagnosis. The remainder of the patients are informed of a dismal prognosis and undergo palliative care through systemic chemotherapy.
Multiple modalities are involved in the staging and diagnosis of this disease. However, there seems to be a controversy regarding a gold standard or whether a gold standard exists. Additionally, there are various emerging techniques that warrant heightened sensitivity and specificity in their designated modalities. Transabdominal ultrasound that is most commonly used as the first-line imaging for patients with epigastric pain is found to be virtually insensitive to neoplasms that have a size of 2 cm or less, limiting its application. However, sonographers could resort to contrasts and elastography to increase the conspicuity of the neoplasms. Moreover, endoscopic ultrasound has shown to be a promising imaging modality with an unprecedented degree of sensitivity to tumors with a diameter less than 1.5cm.
The sensitivity and specificity values of MDCT, MRI and PET/CT were found to be comparable.
The main deductions consist of the fact that EUS is a highly sensitive test that should be accompanied by MRI, MDCT, PET/CT or TUS to increase its specificity. Lastly, empathetic communication is vital not only for patient comfort but also to improve the quality of the imaging assessment. Keywords: PDAC, US, MDCT, MRI, Efficacy
Published in RABM