Radiology of pancreatic adenocarcinoma: Current status of imaging

Pancreatic adenocarcinoma is one of the leading causes of cancer death in the West, with a poor overall 5‐year survival rate of only 4%. Late clinical presentation with an advanced disease results in a low rate of surgical intervention. Tumor serum marker CA 19‐9 is sensitive, although not specific for the diagnosis of adenocarcinomas of the pancreas. The treatment approach is based on whether the tumor is resectable or non‐resectable at presentation. Therefore, imaging plays a crucial role in the management of this disease. Many modalities are available to image the pancreas. They include non‐invasive techniques, like ultrasound, contrast‐enhanced multidetector computed tomography, magnetic resonance imaging and integrated positron emission tomography/computed tomography, and invasive techniques, like endoscopic retrograde cholangiopancreatography and endoscopic ultrasound. Each of these modalities has its peculiar strengths and weaknesses.