Challenges in diagnosis of pancreatic cancer

Table 1 Benefits and limitations of pancreatic cancer diagnostic modalities

Diagnostic modalities	Advantages	Limitations
MDCT	Most commonly available Best validated Cheapest	Nephrotoxicity Radiation exposure
MRI	Superior imaging Depiction of local pancreatic disease Iodine-free and no radiation	Expensive Less available Contraindicated with some metal implants
EUS +/- FNA	Safe and less invasive High sensitivity Able to detect small lesions Able to take histological sample	Less available in some countries Operator dependent Inability to detect distant metastasis
PET/CT	Metastatic disease detection Clarification of equivocal CT findings Monitoring recurrence and response to adjuvant therapy	Expensive Less available Radiation and contrast exposure

CT: Computed tomography; MDCT: Multi-detector computed tomography; MRI: Magnetic resonance imaging; EUS: Endoscopic ultrasound; FNA: Fine needle aspiration; PET: Positron emission tomography.