Helical computed tomography of the pancreas: potential impact of higher concentrated contrast agents and multidetector technology.

The introduction of multidetector helical computed tomography (CT) has revolutionized the field of pancreatic imaging and has created a new dimension of temporal and spatial resolution. The speed of multidetector CT can either be used to reduce the time needed to cover a given volume or to increase the resolution along the z-axis, thereby resulting in nearly isotropic voxels. Pancreatic perfusion phases can thus be more clearly differentiated and small structures are better delineated, leading to an improvement in the diagnostic value of pancreatic CT. Contrast media with a higher iodine concentration seem to be superior to lower concentrated contrast agents, mainly because of the better evaluability of the vessels in the arterial examination phase. This manuscript reports current CT imaging strategies for patients with pancreatic cancer with emphasis on vascular invasion, lymph node metastasis, liver metastasis, and peritoneal carcinomatosis.