Some Imaging Tests May Help Diagnose and Stage Pancreatic Cancer

A new research review from AHRQ found that current evidence permits tentative conclusions about the comparative effectiveness of imaging tests for diagnosing and determining the extent of the spread of pancreatic cancer, but research gaps remain. The evidence showed that multidetector computed tomography (MDCT) and endoscopic ultrasound with fine needle aspiration (EUS-FNA) have similar accuracy in assessing resectability in patients who have undergone an assessment of the spread, or staging, of the disease. EUS-FNA has a slight advantage over MDCT with respect to tumor staging (specifically, a lower chance of undersizing the tumor), according to the new review, “Imaging Tests for the Diagnosis and Staging of Pancreatic Adenocarcinoma.” However, MDCT and magnetic resonance imaging (MRI) are similarly accurate with respect to both diagnosing and assessing vessel involvement, and positron emission tomography–computed tomography (PET/CT) is more accurate than MDCT in assessing distant metastases. Prominent gaps in evidence include minimal information on MDCT angiography; imprecise data on other imaging techniques; a lack of comparative data on patient-oriented outcomes and factors that could influence comparative accuracy; and lack of test-specific data on screening accuracy.