Comprehensive preop erative assessment of pancreatic adenocarcinoma with 64-section volumetric CT

Pancreatic adenocarcinoma is a common gastrointestinal malignancy that has a poor prognosis and for which successful surgical resection is the only method of cure. Preoperative staging and assessment can be performed with a number of modalities. Multidetector (64-section) volumetric computed tomography (CT) allows rapid anatomic coverage coupled with excellent spatial resolution. Understanding the technical parameters necessary for successful pancreatic CT angiography is crucial. Carefully timed scan acquisition maximizes the difference in attenuation between the neoplasm and the pancreatic parenchyma and allows accurate local and distant staging as well as assessment of local resectability. In addition, angiographic data sets can be rendered to create displays of the local venous and arterial anatomy that are familiar to surgeons. Advanced rendering can also be used to create pancreaticographic type images. The TNM system of staging for pancreatic adenocarcinoma is not frequently included in radiology reporting but is important for deciding on optimal therapy and neoadjuvant therapy. (C) RSNA, 2007