Diagnosis of Pancreatic Tumors

Prompt diagnosis and accurate treatment planning depend upon precise pathology and state-of-the-art diagnostics and imaging. Our pancreas team uses the following procedures:

  • Pancreas protocol computed tomography (CT) scan: An x-ray machine linked to a computer takes a series of high resolution pictures. The computer puts the x-rays together to create images of the pancreas and other organs and blood vessels in the abdomen.
  • Angio-3D CT: A more complex CT scan that shows the complex anatomical structures around the cancer in 3D. This allows surgeons and radiation oncologists to develop the best management plan.
  • MRI/Magnetic Resonance cholangiopancreatography (MRCP): A magnetic resonance imaging (MRI) scan¬†uses powerful magnets and radio waves to take clear pictures of the pancreas and bile ducts. No contrast dye or radiation is needed with MRCP.
  • Endoscopic ultrasound (EUS): A thin, lighted tube (endoscope) is passed through the patient's mouth and stomach into the first part of the small intestine. At the tip of the endoscope is an ultrasound device. The doctor slowly withdraws the endoscope from the intestine toward the stomach to make images of the pancreas and surrounding organs and tissues. A biopsy may be taken during this procedure to confirm diagnosis.
  • Endoscopic retrograde cholangiopancreatography (ERCP): After an endoscope is passed through the patient's mouth, stomach, and into the first part of the small intestine, a smaller tube (catheter) is passed through the endoscope and into the bile ducts and pancreatic ducts. Dye is injected through the catheter to the duct, and x-rays then show whether the ducts are blocked from a tumor or other condition.
  • Percutaneous transhepatic cholangiography (PTC): This procedure involves injecting a dye through a thin needle inserted through the skin into the liver. On x-ray, the physician can see whether the dye moves freely through the bile ducts, or whether they are blocked from a tumor or other condition.
  • Image-guided biopsy: This procedure obtains a small piece of the cancer under the guidance of imaging scans, such as CT, MRI and ultrasound. As a high volume center, our experienced physicians perform this accurately and expediently, allowing faster treatment planning.
  • Blood tests: Measuring the number of certain cells or the level of certain chemicals or other substances in your blood can indicate whether pancreas cancer may be present or assess your response to treatment. These may include:
    • CA 19-9: A blood protein that is measured at high levels in people with pancreas cancer.
    • Bilirubin: A substance in bile that may reach high levels in the blood if the bile duct is blocked. High bilirubin in the blood causes jaundice and increased CA 19-9 levels.
    • Complete blood count:¬†Too few or too many cells may suggest cancer, among other conditions.