Pancreatic Cancer

Diagnosis

Mayo Clinic uses various effective tools to diagnose pancreatic cancer.

Ultrasound

Sound waves can be used to form images of the abdomen that identify the presence of a tumor. Ultrasound is performed by placing a probe on the surface of the abdomen while looking at the image on the screen. This procedure is noninvasive and painless.

Computed Tomography (CT) and Magnetic Resonance Imaging (MRI) Scans

CT scans generate two-dimensional images of the body that can show whether cancer has invaded other tissues or organs. All CT scanners at Mayo Clinic use modern spiral CT technology (X-ray tube revolves around patient) and several CT scanners use multi-detector row spiral technology. Spiral CT scans produce high-resolution images in any two-dimensional plane, while multi-detector row spiral CT scans can create high-resolution images in three dimensions.

MRI technology uses magnetic fields and radio waves to create detailed images of the pancreas. Designed to be highly sensitive, this technology can identify small abnormalities.

Endoscopic Retrograde Cholangiopancreatography (ERCP)

In ERCP, a thin flexible tube (endoscope) is passed down the throat, through the stomach and into the upper small intestine. Physicians direct the tube toward the ducts that lead to the pancreas, dye is injected into the pancreas, and X-rays of the ducts are taken. The ducts are common sites of pancreatic cancer.

Endoscopic Ultrasound (EUS)

In endoscopic ultrasound, an ultrasound probe is passed through an endoscope into the stomach. Sound waves are directed toward the pancreas and a computer translates them into images. These images are especially useful in identifying small pancreatic tumors and in determining the disease's stage.

Percutaneous Transhepatic Cholangiography (PTC)

In this procedure a thin needle is inserted into the liver to deliver dye to the bile ducts. A fluoroscope (specialized X-ray machine) tracks the dye as it moves toward the pancreas. This test identifies any obstructions that could be tumors.

Biopsy

Although other diagnostic tools are very accurate, a biopsy still may be recommended. During a biopsy, a small tissue sample collected by fine-needle aspiration (FNA) is examined under a microscope by a pathologist. In FNA, a physician administers local anesthetic, then gently guides a small needle through the skin and abdomen into the pancreas. Ultrasound or CT scans help the radiologist locate the tumor. Tissue samples can also be obtained during ERCP or EUS.

During ERCP, an endoscope is passed into the bile duct where it empties into the small intestine. But instead of injecting dye, the surgeon scrapes cells from the lining of the duct with a small brush. EUS may be combined with FNA to gather both ultrasound images and sample tissue cells.

Laparoscopy

Laparoscopy is performed in an operating room under general anesthesia. The surgeon guides a small camera into the abdomen through a half-inch incision. The surgeon views the images to determine if the tumor has spread outside the pancreas to other organs or structures inside the abdomen. A tissue sample can be collected during this procedure.