Evaluation of pancreatic cancer and the role of imaging measures

The article was professionally consulted by Specialist Doctor I Nguyen Truong Duc - Radiologist - Department of Diagnostic Imaging and Nuclear Medicine - Vinmec Times City International Hospital. Dr. Duc has more than 17 years of experience in diagnostic imaging.

Pancreatic cancer is a tumor in the pancreas. Patients may have blood, urine, biopsy, or tissue tests to identify cancer. Tests such as whole body MRI, whole body CT, MRCP, endoscopic ultrasound, PET/CT are also useful in identifying cancer and checking its metastasis.

Pancreatic cancer begins in the pancreas, an organ located deep in the abdomen behind the stomach. The pancreas secretes hormones called insulin and glucagon to help the body process sugar. It also produces enzymes to help the body digest fats, carbohydrates, and proteins.
Pancreatic cancer occurs when abnormal cells grow out of control and develop into a tumor. Most pancreatic tumors start in the cells lining the ducts of the pancreas and are called adenocarcinomas. Pancreatic tumors that start in hormone-producing cells are called pancreatic neuroendocrine tumors or islet cell tumors.
Risk factors for pancreatic cancer include smoking, being overweight, diabetes, age, testing positive for the BRCA2 gene, and having a history of pancreatitis (inflammation of the pancreas) or family history of cancer pancreatic letter.

Pancreatic cancer patients often have a number of symptoms that prompt them to seek medical attention, such as persistent severe abdominal pain, nausea, jaundice, and unexplained weight loss.

Most diagnostic tests for pancreatic cancer are imaging tests. To determine pancreatic cancer and how far it has spread, your doctor may order one or more of the following tests.
Tumor markers: Like many cancers, pancreatic tumors secrete toxins that can be detected in blood, urine, or tissue samples. Your doctor will check for elevated levels of carcinoembryonic antigen (CEA) or CA 19-9, which is a tumor marker for pancreatic cancer. Elevated CEA levels are common but not always found in patients with pancreatic cancer. MRI (magnetic resonance imaging): This imaging test uses a magnetic field and radiofrequency pulses to create detailed images of internal organs. It is useful in detecting diseases that are not easily seen on other scans and are not related to radiation. CT Scan (CAT): A computerized tomography (CT) scan of the body with special X-ray equipment helps to detect a variety of diseases and conditions. CT scanning is fast, painless, non-invasive and highly accurate. For pancreatic cancer, iodinated contrast media can be used to better visualize the pancreas and surrounding blood vessels. PET scan, also known as positron tomography (PET): PET is a type of nuclear medicine scan that uses a small amount of radioactive material to take pictures of body functions. The PET/CT test combines images from PET and CT scans to detect and locate the cancer and determine the extent of metastasis. Endoscopic ultrasound: In this procedure, a thin tube is inserted through the esophagus into the abdomen. An ultrasound device at the end of the tube sends out sound waves to create images of the pancreas, blood vessels, and nearby tissues. Endoscopic retrograde cholangiopancreatography (ERCP): This test uses a combination of endoscopy and X-ray imaging to examine the bile ducts, liver, gallbladder, and pancreas. When this test is done, a thin optical instrument, called an endoscope, is inserted through the esophagus into the small intestine to visualize the organs and ducts. Contrast is also injected into the small intestine and combined with X-rays. Percutaneous cholangiography (PTC): PTC is an X-ray procedure. The imaging steps include injecting contrast material directly into the intrahepatic bile ducts to create an image of the biliary tree. Magnetic resonance cholangiopancreatography (MRCP): MRCP uses a strong magnetic field, radio waves, and a computer to create detailed images of the hepatobiliary system and pancreas, including the liver, gallbladder, biliary tract, and glands. pancreas and pancreatic duct. Biopsy: A biopsy is the removal of tissue from any part of the body to look at disease conditions. Pancreatic biopsy samples are usually obtained by inserting a fine needle through the skin directly into the pancreas or by taking a sample during endoscopic ultrasound with a special tool attached to the endoscope.

Patients with pancreatic cancer often have no symptoms until the tumor has spread to surrounding organs. Eight out of 10 patients are diagnosed after the cancer has moved outside of the pancreas. Among the ways to diagnose pancreatic cancer, the use of imaging procedures is quite popular and has many outstanding advantages, especially computed tomography (CT).
Computerized tomography not only helps the doctor to accurately identify the tumor but also assess the degree of metastasis of the tumor so that there can be surgical direction and early treatment for the patient. In addition, when compared with other forms of imaging in diagnosing pancreatic cancer, CT scans will give us clearer images than ultrasound or X-rays. CT scan time is relatively quick, so it will help diagnose quickly and have timely treatment. For patients who are unable to undergo magnetic resonance imaging for some reason, computed tomography is a very effective option.
However, the use of CT scans or any other methods to diagnose pancreatic cancer should also be analyzed and considered carefully by experienced doctors, because using these diagnostic methods also has potential risks. certain limitations such as the effect of radiation rays on the body.
Abdominal ultrasound is a widely used imaging method, with the advantage of being non-invasive, fast, and inexpensive. But the accuracy of ultrasound in diagnosing pancreatic cancer is only 50-70%, the diagnostic results are highly dependent on the sonographer. In addition, ultrasound is also limited by factors such as obesity, gas in the intestines...
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Reference source: radiologyinfo.org
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