Divisions of Abdominal and Cardiothoracic Imaging Emory University School of Medicine 1364 Clifton Rd. NE, Atlanta, GA 30329, Phone: (404) 778-3800
Pancreatic ductal adenocarcinoma (PDA) is the second most common gastrointestinal malignancy and the fourth leading cause of all cancer-related deaths in the US. It is a highly aggressive tumor that continues to carry a high mortality rate continues to carry a poor prognosis. This can be attributed to the lack of early detection and the aggressive disease biology and early systemic spread of disease. Surgical resection remains the only curative option; however, at the time of diagnosis only minority of the patients are deemed resectable. With limited improvements in the treatment of advanced PDA, the main hope for improved patient survival and potential cure lies in early detection of the disease when complete surgical resection is feasible. Any patients with PDA evaluated by a pancreatic surgeon may require a high-risk surgical procedure that offers the only chance of cure. Accurate staging of PDA (identifying anatomic relationship of the tumor and critical vessels as well as extrapancreatic disease) carries substantial implications for appropriate recommendation of the most suitable treatment option, thus maximizing the survival benefit for patients in whom complete resection can be achieved and minimizing the morbidity from unnecessary laparotomy or major surgery in patients with high risk of residual disease following resection. In this two-part talk, we will discuss pretreatment imaging evaluation of patients with PDA and respectability criteria. We will also discuss role of radiologist for tumor restaging after neoadjuvant therapy.