Pancreatic adenocarcinoma: designing the examination to evaluate the clinical questions.

The dynamic incremental bolus technique and modifications in slice thickness can be used to tailor current computed tomographic (CT) technology to evaluate the extent of pancreatic cancer. Contrast material administered intravenously allows visualization of small lesions, an assessment of vascular invasion versus patency, and maximal conspicuity and detectability of hepatic metastases. CT findings in 104 cases of pancreatic cancer studied during 1979-1982 (group A) were compared with findings in 107 cases of pancreatic cancer studied during 1984-1987 (group B). Masses in the body and tail of the pancreas were recognized in 96% (n = 103) of cases in group B and 89% (n = 93) in group A. Masses in the head of the gland were detectable in 94% (n = 101) of cases in group B and 76% (n = 79) of cases in group A. Hypoattenuating tumors were detectable in 78% (n = 83) of cases in group B, as opposed to 24% (n = 25) in group A. CT is the primary diagnostic technique in the evaluation of pancreatic adenocarcinoma.