Multimodality imaging of pancreatic cancer-computed tomography, magnetic resonance imaging, and positron emission tomography

Pancreatic adenocarcinoma continues to have a dismal prognosis, with curative surgery (resection with negative margins) possible in only a small percentage of patients. Not only does radiological imaging play a major role in diagnosing the primary lesion at presentation, but it is also crucial for staging of locoregional disease and distant metastases, both of which are critical for selecting appropriate candidates for surgery. Over the last 2 decades, computed tomography has become the dominant imaging modality for both the diagnosis and staging of pancreatic cancer, with advances in multidetector computed tomography technology improving the ability to identify small tumors and demonstrate subtle degrees of vascular involvement by tumor. However, magnetic resonance imaging and positron emission tomography are now playing an increasing role in pancreatic cancer imaging. These 3 imaging modalities each have specific strengths and benefits and should be used in a complementary fashion.