Written by a team of expert authors from all members of the multidisciplinary cancer care team, Pancreatic Cancer summarizes our current understanding of the epidemiology, genetics, imaging and treatment of these complex malignancies. Each imaging modality is reviewed, with an emphasis on MDCT, MRI and EUS; the key aspects of image interpretation are covered. Separate chapters focus on diagnosis and staging of ductal adenocarcinoma, cystic pancreatic neoplasms and neuroendocrine tumors; rare neoplasms and benign pancreatic disorders that mimic pancreatic cancer are also considered. All treatment options are discussed in detail, including surgery, chemotherapy and radiation therapy, and the multidisciplinary approach to patients with more advanced disease is fully reviewed. This volume is a state-of-the-art review of current practice and knowledge of pancreatic cancer.
Author(s): Jay Heiken
Series: Contemporary Issues in Cancer Imaging
Edition: 1
Publisher: Cambridge University Press
Year: 2009
Language: English
Commentary: 41694
Pages: 218
Cover......Page 1
Half-title......Page 3
Series-title......Page 5
Title......Page 7
Copyright......Page 8
Contents......Page 9
Series Foreword......Page 11
Preface to Pancreatic Cancer......Page 12
Contributors......Page 13
Epidemiology......Page 15
Intraductal papillary mucinous neoplasms......Page 16
Mucinous cystic neoplasms......Page 18
Hereditary pancreatic cancer syndromes......Page 19
Conclusions......Page 20
References......Page 22
Ductal adenocarcinoma......Page 24
Precursors to ductal carcinoma: pancreatic intraepithelial neoplasia......Page 30
Intraductal papillary mucinous neoplasm (IPMN)......Page 31
Mucinous cystic neoplasm (MCN)......Page 33
Acinar cell carcinoma (ACC)......Page 34
Solid pseudopapillary tumor (SPT) (also called solid pseudopapillary epithelial neoplasm – SPEN)......Page 35
Pancreatic endocrine neoplasm (PEN)......Page 37
Serous cystic neoplasms......Page 38
References......Page 39
MDCT pancreatic protocol components......Page 42
Radiation dose......Page 43
Oral contrast......Page 44
Intravenous contrast-dose......Page 45
Acquisition timing and phases of imaging......Page 46
Reconstruction parameters......Page 47
Additional MDCT imaging techniques......Page 50
Accuracy of MDCT......Page 53
MDCT and other forms of pancreatic neoplasms......Page 54
References......Page 57
Introduction......Page 60
Non-contrast MR sequences......Page 61
Contrast-enhanced MR sequences......Page 63
Magnetic resonance cholangiopancreatography (MRCP)......Page 64
Supplementary and emerging techniques......Page 67
Conclusion......Page 69
References......Page 70
Introduction......Page 72
Detection of pancreatic ductal cancer......Page 73
Contrast dose, injection rate and scan timing......Page 77
Post processing......Page 79
Magnetic resonance imaging technique......Page 88
Endoscopic ultrasound......Page 92
Positron emission tomography with computed tomography......Page 93
References......Page 94
Introduction......Page 97
Serous cystic neoplasms......Page 107
Mucinous cystic neoplasms......Page 108
Intraductal papillary mucinous neoplasms......Page 111
Solid pseudopapillary epithelial neoplasm (also called solid pseudopapillary tumor)......Page 116
Cystic pancreatic endocrine neoplasm......Page 118
Miscellaneous and rare lesions......Page 120
Management......Page 121
References......Page 123
Introduction......Page 126
Insulinoma......Page 127
VIPoma......Page 129
Somatostinoma......Page 130
Carcinoid......Page 131
Insulinoma......Page 132
Gastrinoma......Page 135
Glucagonoma......Page 137
VIPoma......Page 138
Other hyperfunctioning tumors......Page 139
Radiographic imaging features and results for N-NENs (Figures 7.7–7.8)......Page 140
Role of imaging for NENs......Page 141
Treatment......Page 144
References......Page 145
Introduction......Page 152
Diagnosis of pancreatic adenocarcinoma......Page 153
Endoscopic ultrasound with fine needle aspiration......Page 155
Staging of pancreatic adenocarcinoma......Page 158
Endoscopic ultrasound evaluation of cystic lesions......Page 160
Endoscopic ultrasound in the evaluation of pancreatic endocrine neoplasms......Page 164
References......Page 166
Oncologic rationale for surgical resection of adenocarcinoma of the head of the pancreas......Page 172
Clinical presentation......Page 176
Typical mass......Page 177
Surgical staging (determination of resectability)......Page 178
Results of resection for adenocarcinoma of the head of the pancreas......Page 180
Oncologic rationale for surgical resection of adenocarcinoma of the body and tail of the pancreas; radical antegrade modular pancreato-splenectomy (RAMPS)......Page 181
Diagnosis and staging......Page 182
Results of resection for adenocarcinoma of the body and tail of the pancreas......Page 184
References......Page 185
Locally advanced pancreatic adenocarcinoma......Page 188
Metastatic pancreatic adenocarcinoma......Page 192
Symptomatic management......Page 193
References......Page 194
Rare carcinomas......Page 197
Lymphoma......Page 199
Metastasis......Page 201
Lymphoepithelial cyst......Page 202
Other mesenchymal tumors......Page 204
True cysts......Page 205
Autoimmune pancreatitis......Page 206
Groove pancreatitis......Page 207
Intrapancreatic accessory spleen......Page 209
Focal fatty replacement......Page 210
References......Page 211
Index......Page 215
