| Theme | Advances in Diagnosis and Endoscopic Treatment for Pancreatic and Biliary Lesion | |
|---|---|---|
| Title | Strategy for Diagnosis of Pancreatic and Biliary Carcinomas | |
| Publish Date | 2007/06 | |
| Author | Go Kobayashi | Department of Gastroenterology, Sendai City Medical Center |
| Author | Naotaka Fujita | Department of Gastroenterology, Sendai City Medical Center |
| Author | Yutaka Noda | Department of Gastroenterology, Sendai City Medical Center |
| Author | Kei Ito | Department of Gastroenterology, Sendai City Medical Center |
| Author | Jun Horaguchi | Department of Gastroenterology, Sendai City Medical Center |
| Author | Osamu Takasawa | Department of Gastroenterology, Sendai City Medical Center |
| Author | Takashi Obana | Department of Gastroenterology, Sendai City Medical Center |
| Author | Kazuari Nakahara | Department of Gastroenterology, Sendai City Medical Center |
| [ Summary ] | The role of diagnostic imaging is vast in the diagnosis of biliopancreatic malignancies. Transabdominal ultrasound (US) and magnetic resonance cholangiopancreatography (MRCP) have made it possible to detect bile duct / main pancreatic duct dilatations noninvasively. Recently, patients with pancreatic cystic lesions, including intraductal papillary mucinous neoplasms, are considered to have an increased risk of pancreatic carcinoma. For detection of such cystic lesions of the pancreas, US and MRCP are quite useful. In the near future, PET-CT and diffusion MRI are also likely to play pivotal roles, in the screening of pancreatic carcinoma. Multidetector row CT (MDCT) is very useful in the evaluation of the tumor extent of pancreatic carcinoma and hilar cholangio carcinoma. EUS is the most efficacious modality for the detection and staging of small pancreatic carcinoma, as well as for the T-staging of gallbladder carcinoma. Another modality widely recognized for its usefulness in the diagnosis and treatment of pancreatobiliary diseases is ERCP. Transpapillary intraductal ultrasonography, in combination with transpapillary biopsies before drainage, is also a very useful modality, characterized by high diagnostic accuracy in the evaluation of the longitudinal spread of bile duct carcinoma. Appropriate selection of these various modalities is crucial for efficacious establishment of a diagnosis of biliopancreatic carcinoma. |
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