Pancreatic cancer diagnostic study of choice
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief:
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Overview
Diagnostic Study of Choice
Gold standard/Study of choice:
- MDCT (Multi-detector row computed tomography) the imaging modality widely used in suspected pancreatic cancer patients as the pre-operative examination. [1]
- MDCT is used as the primary imaging modality, and is used in conjunction with PET/CT. MDCT helps in local and distant disease assessment in a single scan. [2]
- MDCT is useful in the evaluation of vascular involvement, which helps in predicting the tumor resectability.[1] [1]
- The dynamic spiral CT scan with contrast media(oral and IV) enhancement is the gold standard test for the diagnosis and staging of pancreatic cancer.
- The following result of CT scan is confirmatory of pancreatic cancer: [3] [4][5][6][7]
- Morphological changes of the gland
- Destruction of the peripancreatic fat and loss of the sharp margins with surrounding structures
- Involvement of the regional lymph nodes and adjacent vasculature
- Pancreatic ductal dilatation
- Pancreatic atrophy
- Obstruction of the common bile duct (CBD)
Diagnostic Criteria
- Here you should describe the details of the diagnostic criteria.
- Always mention the name of the criteria/definition you are about to list (e.g. modified Duke criteria for diagnosis of endocarditis / 3rd universal definition of MI) and cite the primary source of where this criteria/definition is found.
- Although not necessary, it is recommended that you include the criteria in a table. Make sure you always cite the source of the content and whether the table has been adapted from another source.
- Be very clear as to the number of criteria (or threshold) that needs to be met out of the total number of criteria.
- Distinguish criteria based on their nature (e.g. clinical criteria / pathological criteria/ imaging criteria) before discussing them in details.
- To view an example (endocarditis diagnostic criteria), click here
- If relevant, add additional information that might help the reader distinguish various criteria or the evolution of criteria (e.g. original criteria vs. modified criteria).
- You may also add information about the sensitivity and specificity of the criteria, the pre-test probability, and other figures that may help the reader understand how valuable the criteria are clinically.
- [Disease name] is mainly diagnosed based on clinical presentation. There are no established criteria for the diagnosis of [disease name].
- There is no single diagnostic study of choice for [disease name], though [disease name] may be diagnosed based on [name of criteria] established by [...].
- The diagnosis of [disease name] is made when at least [number] of the following [number] diagnostic criteria are met: [criterion 1], [criterion 2], [criterion 3], and [criterion 4].
- The diagnosis of [disease name] is based on the [criteria name] criteria, which includes [criterion 1], [criterion 2], and [criterion 3].
- [Disease name] may be diagnosed at any time if one or more of the following criteria are met:
- Criteria 1
- Criteria 2
- Criteria 3
IF there are clear, established diagnostic criteria:
- The diagnosis of [disease name] is made when at least [number] of the following [number] diagnostic criteria are met: [criterion 1], [criterion 2], [criterion 3], and [criterion 4].
- The diagnosis of [disease name] is based on the [criteria name] criteria, which include [criterion 1], [criterion 2], and [criterion 3].
- The diagnosis of [disease name] is based on the [definition name] definition, which includes [criterion 1], [criterion 2], and [criterion 3].
IF there are no established diagnostic criteria:
- There are no established criteria for the diagnosis of [disease name].
References
References
- ↑ 1.0 1.1 1.2 Lee ES, Lee JM (2014). "Imaging diagnosis of pancreatic cancer: a state-of-the-art review". World J Gastroenterol. 20 (24): 7864–77. doi:10.3748/wjg.v20.i24.7864. PMC 4069314. PMID 24976723.
- ↑ Brennan DD, Zamboni GA, Raptopoulos VD, Kruskal JB (2007). "Comprehensive preoperative assessment of pancreatic adenocarcinoma with 64-section volumetric CT". Radiographics. 27 (6): 1653–66. doi:10.1148/rg.276075034. PMID 18025509.
- ↑ Horwhat JD, Gerke H, Acosta RD, Pavey DA, Jowell PS (2009). "Focal or diffuse "fullness" of the pancreas on CT. Usually benign, but EUS plus/minus FNA is warranted to identify malignancy". JOP. 10 (1): 37–42. PMID 19129613.
- ↑ Freeny PC, Marks WM, Ryan JA, Traverso LW (1988). "Pancreatic ductal adenocarcinoma: diagnosis and staging with dynamic CT". Radiology. 166 (1 Pt 1): 125–33. doi:10.1148/radiology.166.1.2827228. PMID 2827228.
- ↑ Karasawa E, Goldberg HI, Moss AA, Federle MP, London SS (1983). "CT pancreatogram in carcinoma of the pancreas and chronic pancreatitis". Radiology. 148 (2): 489–93. doi:10.1148/radiology.148.2.6867347. PMID 6867347.
- ↑ Raptopoulos V, Steer ML, Sheiman RG, Vrachliotis TG, Gougoutas CA, Movson JS (1997). "The use of helical CT and CT angiography to predict vascular involvement from pancreatic cancer: correlation with findings at surgery". AJR Am J Roentgenol. 168 (4): 971–7. doi:10.2214/ajr.168.4.9124153. PMID 9124153.
- ↑ Asagi A, Ohta K, Nasu J, Tanada M, Nadano S, Nishimura R; et al. (2013). "Utility of contrast-enhanced FDG-PET/CT in the clinical management of pancreatic cancer: impact on diagnosis, staging, evaluation of treatment response, and detection of recurrence". Pancreas. 42 (1): 11–9. doi:10.1097/MPA.0b013e3182550d77. PMID 22699206.