The imaging of pancreatic masses has evolved considerably since the introduction of multidetector computed tomography (MDCT). This new technology has enabled the acquisition of thinner slices during multiphasic scanning, with improved spatial resolution of axial, multiplanar reformatted, and 3-dimensionaI (3D) images.
Pancreatic adenocarcinoma is the most common malignancy of the pancreas and accounts for up to 90% of all pancreatic tumors. Other, less common causes of pancreatic masses include solid tumors (such as islet cell tumor [ICT]), lymphoma, mesenchymal tumor, metastasis to the pancreas as well as a variety of cystic lesions. Inflammatory masses of the pancreas related to either acute or chronic pancreatitis may also simulate a pancreatic neoplasm (Figure 1).
MDCT allows multiphasic contrast-enhanced scans of the pancreas, so that data is acquired during optimal pancreatic enhancement, aiding tumor detection. Optimum vascular opacification is also more reliable, enabling assessment of vascular invasion by tumor. The pancreas may also be scanned using thinner slices, which improves resolution and can aid in the detection of smaller lesions.