To characterize the imaging findings of visually isoattenuating pancreatic adenocarcinoma in MDCT,
their secondary signs and their correlation with MRI and US.
Isoattenuating pancreatic adenocarcinoma represent a small but significant percentage of pancreatic cancer (5,4 %) (1,2). Histologically,
these tumors are characterized by lower tumor cellularity,
more frequent association with intratumoral acinar tissues and islet cells and less frequent tumor necrosis compared with usual pancreatic adenocarcinomas.
Isoattenuating tumors have a “loose fibrosis” in contrast to the “dense fibrosis” seen in hypodense adenocarcinomas,
which is supposed...
Findings and procedure details
We reviewed MDTC performed in 85 patients with a suspected pancreatic mass between September 2009 and May 2016.
We obtained in all the cases multiplanar dynamic dual-phase scan,
and MIP reformatted images.
Isoattenuating tumors were found in 10 of them,
all histologically confirmed at surgery (n= 7) or biopsy (n= 3).
The most common location was the pancreatic head (70%),
followed by the body (20%) and uncinate process (10%). Fig. 1 These cases were diagnosed by MRI in 40 %,
US in 30 %,
Isoattenuating pancreatic tumors are a small percentage of pancreatic adenocarcinoma with a higher postsurgical survival.
the detection of secondary signs in MDTC is useful to achieve an early diagnosis.
Although US may be a more sensitive method in the detection of these tumors in cases with adequate glandular visualization; MRI can improve the diagnosis providing better tissue characterization,
especially with diffusion sequence and ADC map.
Visually Isoattenuating Pancreatic Adenocarcinoma at Dynamic – Enhanced CT: Frequency,
Clinical and Pathological Characteristics,
and Diagnosis at Imaging Examinations.
Radiology 2010; 257: 87-96. Yoon SH,
Small (<20 mm) Pancreatic Adenocarcinomas: Analysis of Enhancement Patterns and Secondary Sigs with Multiphasic Multidetector CT.
Radiology 2011; 259: 442-452. Miura F,
Diagnosis of Pancreatic Cancer.