Comprehensive preoperative assessment of pancreatic adenocarcinoma with 64-section volumetric CT

Pancreatic adenocarcinoma is a common gastrointestinal malignancythat has a poor prognosis and for which successful surgical resection isthe only method of cure. Preoperative staging and assessment can beperformed with a number of modalities. Multidetector (64-section)volumetric computed tomography (CT) allows rapid anatomic coveragecoupled with excellent spatial resolution. Understanding the technicalparameters necessary for successful pancreatic CT angiography iscrucial. Carefully timed scan acquisition maximizes the difference inattenuation between the neoplasm and the pancreatic parenchyma andallows accurate local and distant staging as well as assessment of localresectability. In addition, angiographic data sets can be rendered tocreate displays of the local venous and arterial anatomy that are familiarto surgeons. Advanced rendering can also be used to create pancreaticographictype images. The TNM system of staging for pancreaticadenocarcinoma is not frequently included in radiology reporting but isimportant for deciding on optimal therapy and neoadjuvant therapy.