Radiology
Medical imaging
Pancreatic cancer remains one of the deadliest forms of cancer and early diagnosis is critical to improve the likelihood of a positive treatment outcome.
Imaging tests help doctors find out where the cancer is located and whether it has spread from the pancreas to other parts of the body.
Imaging tests may also be used to monitor whether the cancer is growing or regressing. Pancreatic cancer often does not develop as a single large tumour, which means it can sometimes be difficult to see on imaging tests. However, newer computed tomography scanners (see below) produce better, clearer images that can make it easier to find a tumour.
Imaging tests are reported by specialist radiologists and reviewed at our specialist multi-discontinuer team meeting.
What is a CT or Cat scan?
A CT or Computed Tomography takes pictures of the inside of the body using x-rays taken from different angles. A computer combines these pictures into a detailed, 3-dimensional image that shows any abnormalities or tumours. A CT scan can be used to determine the size and location of the tumour and whether it has spread to lymph nodes or other parts of the body. Typically, a special dye called a contrast medium is given before the scan to provide better detail on the image. This dye can be injected into a patient’s vein or given as a liquid to swallow. Many cancer centres use a special CT scan method called a pancreatic protocol CT scan. This method focuses on taking pictures of the pancreas at specific times after the intravenous (IV) injection of contrast medium to find out exactly where the tumour is in relation to nearby organs and blood vessels. The results of this test can help decide if the tumour could be removed with surgery.
What is an ultrasound scan?
Ultrasound uses sound waves to create a picture of the internal organs. There are 2 types of ultrasound devices: transabdominal and endoscopic.
A transabdominal ultrasound device is placed against the outside of the abdomen and is slowly moved around by a technician to produce an image of the pancreas, liver and bile ducts.
What is an Endoscopic Ultrasound?
The endoscopic ultrasound (EUS) device is a thin, lighted tube that is passed through the patient's mouth and stomach and down into the small intestine. It is slowly moved around the area to take a picture of the pancreas. This procedure is very specialized and requires an interventional gastroenterologist who has special training in this area. EUS is generally done under sedation, so the patient sleeps through the procedure. A biopsy can be done at the same time as this procedure. These procedures are performed in operating theatres or specialised endoscopy centres
What is an MRI scan?
MRI uses large magnets that pass around the body to detect the differences in water content of the cells. A computer then interpret these changes in water content and polarisation of the tissues to produce high definition images of the pancreas, liver and bile ducts. MRI scans are particularly useful in looking at cysts (water containing) of the pancreas and can be more sensitive than CT scan for small pancreatic and liver lesions. The MRI scan is in the shape of a tunnel and can be noisy and in some people cause claustrophobia.
What is a Pet scan?
A PET scan is usually combined with a CT scan (see above), called a PET-CT scan. A PET scan is a way to create multi-coloured pictures of organs and tissues inside the body. A small amount of a radioactive sugar substance called a tracer is injected into the patient’s body. This substance is preferentially taken up by cancer cells. A scanner then detects this substance to produce images of the inside of the body. The combination provides a more complete picture of the area being evaluated.
Pet scans. However, they are not yet considered a standard test for pancreatic cancer and are currently not funded by Medicare for the investigation of pancreatic cancer and as such are performed on an individualised basis.
What is an Endoscopic retrograde cholangiopancreatography (ERCP)?
This procedure is performed by an interventional gastroenterologist. The doctor will put a thin, lighted tube called a duodenoscope through the mouth and stomach into the small intestine. Then, a smaller tube called a catheter is passed through the endoscope and into the bile ducts and pancreatic ducts. Dye is injected into the ducts, and the doctor takes x-rays that can show whether a duct is compressed or narrowed. Often, a plastic or metal stent can be placed across the obstructed bile duct during ERCP to help relieve any jaundice. The patient is lightly sedated during this procedure. ERCP is generally used to place bile duct stents and not commonly used for diagnosis.
What is a percutaneous transhepatic cholangiography (PTC)?
In this x-ray procedure, a thin needle is inserted through the skin and into the liver. A dye is injected through the needle, so the bile ducts show up on x-rays. By looking at the x-rays, the doctor can tell whether there is a blockage of the bile ducts and if required insert a stent to relive the blockage. This procedure is performed under sedation or anaesthetic by a specialist interventional radiologist.
Do I have to fast for my procedure?
In general patients must fast for at least 4 hours prior to an imaging procedure so that the best images can be obtained. Check with the imaging provider regarding the specific instructions when your scan is booked.
Will I need a drip for my procedure?
Most procedures, apart from abdominal ultrasound, require an intravenous cannula to be placed so that a contrast dye can be injected to get the best and most accurate images of your body. Check with the imaging provider regarding the specific instructions when your scan is booked.
Where should I have my scan performed?
Scans can be performed by any radiology provider and nearly all receive a rebate from Medicare. Please bring any scans you have to the appointment with your specialist so they can be reviewed at our specialist MDT. We ideally prefer scans to be performed under the supervision of one of our specialist radiologists or gastroenterologist. However, we have software available to view scans performed at any imaging centre or hospital. Please remember to bring all scans whether on disc or paper so your doctors can review them.