In order to diagnose pancreatic cancer, a provider may order one or more imaging tests.
A computed tomography, or CT, scan uses a combination of x-rays and computer technology to create images of internal organs. A special dye, called contrast medium, may be injected to make structures inside the body easier to see.
Magnetic resonance imaging, or MRI, uses radio waves and magnets to produce detailed images of internal organs and soft tissues. In some cases, contrast medium is injected to make structures and problems show up more clearly.
Ultrasound uses high-frequency sound waves to create images of internal organs. A biopsy of an abnormal area of the pancreas may be performed in certain cases by inserting a needle into the pancreas under ultrasonic guidance. Because the pancreas is a deep abdominal organ, ultrasound through the skin may not be very effective. Ultrasound with endoscopy, described below, is usually necessary in these cases.
An endoscope is a thin, flexible tube with a tiny camera at the end that can be passed through the mouth to allow the provider to see inside the digestive tract.
Endoscopic Ultrasound (EUS)
Endoscopic ultrasound, or EUS, uses an endoscope with an ultrasound probe embedded at the tip of the scope. EUS can be helpful in finding small tumors that may be less than two to three centimeters, which can be missed by CT or MRI, and also allows for sampling of pancreatic tissue and abnormal lymph nodes during viewing. For many gastroenterologists, EUS is a first choice modality for any identified pancreatic mass or lesion for both imaging and tissue sampling.
Endoscopic Retrograde Cholangiopancreatography (ERCP)
Endoscopic retrograde cholangiopancreatography, or ERCP, uses an endoscope to view the pancreas, bile ducts, and in certain cases, the pancreatic duct. The endoscope is passed through the mouth, throat, and stomach into the small intestine, and a special dye is injected into the pancreatic and/or bile ducts to help the pancreas, gallbladder, and bile ducts appear on special x-rays. Brushings can be taken during this procedure using a brush inserted into the bile duct, and special tools can sometimes be used to get tiny tissue samples as well.