Radiologic Resectability Assessment in Pancreatic Cancer

Abstract

Complete tumor resection is still the only potentially curative therapy option for patients with ductal adenocarcinoma of the pancreas. Surgical exploration is the gold standard for the determination of tumor resectability. Radiological resectability assessment is of great importance because many clearly unresectable cases can be identified preoperatively and it became essential for surgical planning. The evolving surgical and radiological techniques demand a continuous reappraisal of radiological criteria in resectability assessment. In the following, the criteria for resection planning are described along with surgical management and the role of radiology in some innovative surgical concepts is explained.

Citation Format:

• Denecke T, Grieser C, Neuhaus P et al. Radiologic Resectability Assessment in Pancreatic Cancer. Fortschr Röntgenstr 2014; 186: 23 – 29

Zusammenfassung

Für Patienten mit duktalem Adenokarzinom des Pankreas stellt die vollständige Tumorresektion nach wie vor die einzige potenziell kurative Therapieoption dar. Zur Klärung ob eine Tumorresektion möglich ist gilt die chirurgische Exploration als Goldstandard. Die radiologische Einschätzung der Resektabilität vor der Operation ist von entscheidender Bedeutung, da sie viele eindeutig irresektable Fälle präoperativ identifizieren kann und zur Planung des chirurgischen Eingriffs unverzichtbar geworden ist. Die Weiterentwicklungen chirurgischer Techniken und bildgebender Methoden verlangen eine kontinuierliche Neubewertung der Kriterien für eine Einschätzung der Resektabilität anhand radiologischer Diagnostik. Im Folgenden werden die Kriterien für die Resektionsplanung und das chirurgische Vorgehen beschrieben sowie die Rolle der Radiologie bei einigen innovativen chirurgischen Therapiekonzepten erläutert.

Key words

pancreas - CT - MR imaging - resectability - cancer - staging

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