New advances in pancreatic imaging.

PURPOSE OF REVIEW

Exciting new developments and applications of imaging techniques in pancreatic diseases have emerged. This review discusses these new advances and how they are improving our ability to diagnose malignancies and inflammatory lesions, to grade severity of pancreatitis, and to stage pancreatic cancer accurately.

RECENT FINDINGS

A new computed tomography severity index shows promise for grading the severity of acute pancreatitis. Magnetic resonance imaging is comparable with computed tomography in staging acute pancreatitis. Analysis of pancreatograms and textural changes of the parenchyma may prove helpful in diagnosing chronic pancreatitis. Contrast enhanced ultrasonography may prove to be a useful way to judge the degree of inflammation and fibrosis in autoimmune pancreatitis and to monitor response to steroid therapy. The debate over the best means of staging pancreatic cancer has focused on endoscopic ultrasound and computed tomography. Preliminary studies with contrast enhanced ultrasonography report improved diagnostic and staging capabilities with pancreatic cystic and solid neoplasms. Improvements in positron emission tomography/computed tomography scans may improve the detection of neuroendocrine tumors.

SUMMARY

These new advances will help refine the diagnosis and staging of pancreatic diseases.