Cancer Pancreas

The pancreas is bisected along its longitudinal axis revealing a large adenocarcinoma (B) of the head. (A) is the tail of pancreas which is normal.
The normal pancreas is gray-yellow to tan throughout the organ


What are the useful imaging procedures in the evaluation of cancer pancreas?
Indicate when you would select each procedure.
Sensitivity and specificity of each:
Test Sensitivity Specificity
Ultrasound 80 90
Endoscopic US 90 90
CT scan 90 95
Retrograde cholangiopancreatography 90 90
MRI scan 90 90
What are the imaging findings of cancer pancreas?

carcinoma pancreas

Arrows: Note enhancing mass head of pancreas extending medially into the uncinate process.

carcinoma pancreas

Arrows point to dilated intrahepatic bile ducts indicating obstructive jaundice.

Bile ducts are next to contrast filled branches of the portal vein (PV)

Double arrows point to peri splenic varicocities.

carcinoma pancreas

  • CBD: Dilated common bile duct
  • Arrowheads: Dilated pancreatic duct
  • Arrow: Tail of Pancreas

carcinoma pancreas

  • GB points to dilated gallbladder
  • Arrowheads point to small cysts in pancreatic head

Courvoisier gallbladder

The liver and a distended gallbladder are seen in this nuclear medicine study isotope. However, no excretion of the isotope into the bowel is seen indicating a complete obstruction of the common bile duct.

Isoptope has been taken up by the liver parenchyma and with excretion into GB indicating patent cystic duct. But there is no spill into the duodenum which indicates common bile duct obstruction