How it works: Abdominal ultrasound is a non-invasive technique using directed sound waves to examine the body's internal organs, including the pancreas, gallbladder, liver, kidneys, spleen, stomach, and intestines. The sound waves used are of very high frequency and cannot be heard by the human ear. When the soundwaves bounce off of the internal organs they echo, creating an image called a sonogram. Since healthy tissue and tumors create different echoes, the size of the internal organs as well as the presence of a tumor can be detected using ultrasonography.
What to expect: During the examination, the patient lies on a bed with the abdomen exposed. The sonographer spreads a gel on the abdomen to help an instrument called a transducer slide smoothly across the skin and to help transmit the sound waves into the abdomen without air interference. The transducer is a hand-held instrument that sends the sound waves into the body to create the images. The test is completely painless for the patient and lasts about 20 minutes.
Considerations: If you are undergoing an ultrasound test, you may be asked not to eat or drink for 6-8 hours prior to the test. This is to make sure that only your abdominal organs are imaged. Some people may find the gel cold to the touch.
How it works: CT is one of the most common imaging studies performed when someone is suspected of having pancreatic cancer. In a CT scan, an X-ray machine linked to a computer takes a series of detailed cross-sectional pictures. These "slices" are then linked together to create a detailed 3-dimensional reconstruction of the body. Unlike regular X-ray images which can only show bone, CT images show soft tissue, blood vessels, and bone.
What to expect: The CT scanner is shaped like a giant donut. The patient lies on a bed that slowly passes through the hole as images are taken. While the pictures are being taken during the study, it is important that the patient remain still in order for the images to be as clear as possible.
Often after the first set of pictures is taken, the patient may be asked to drink contrast dye, or may receive an intravenous (IV) line through which the dye is injected. This dye helps to better outline the body structures, show small pancreatic tumors, and to reveal whether the cancer has spread to any other organs.
Considerations: The contrast dye can cause some people to feel warm, red, and flushed. Some people may be allergic to the contrast dye and may get hives. Other, more serious reactions, such as shortness of breath and low blood pressure, can occur but are very rare. If you have ever had a reaction to contrast material used for X-rays in the past, or if you are allergic to shellfish, make sure to tell your doctor.
How it works: MRI is another common diagnostic imaging study used in pancreatic cancer. MRI scans use radio waves and powerful magnets to produce images of the body. Like a CT scan, an MRI can produce detailed 3-dimensional cross-sectional images of the body. The MRI can also produce image slices running the length of the body, providing an alternate view of the affected area.
What to expect: During the scan, the patient lies on a bed inside a narrow tube. The scan usually takes 1 to 1.5 hours. As in a CT scan, it is crucial that the patient remain still during the scan in order to produce the most accurate images possible.
Considerations: MRI can make some people feel uncomfortable and claustrophobic because it requires the patient to lie very still in a narrow cylinder for an extended period of time. Additionally, the MRI machine makes loud noises during the scan which some patients may find disturbing. Some imaging facilities will offer patients headphones to drown out the noise. If you have a history of feeling claustrophobic, consider telling your physician in advance as he may give you a sedative before the test.
How it works? MRCP is a special kind of MRI scan enabling the physician to visualize the bile and pancreatic ducts in a non-invasive way. This is particularly helpful since tumors typically arise in the ducts. At the Pancreas Center, this is a very important test in determining if the patient is a suitable surgical candidate.
What to expect: The MRCP procedure is normally performed concurrently with an MRI study. You will be required to lie on a bed in a narrow tube throughout the study's duration.
Considerations: The same considerations apply to an MRCP procedure as with a regular abdominal MRI. You should be aware that you may feel claustrophobic and be disturbed by the loud noises that the machine makes. You must also lie very still throughout the procedure.
How it works: PET scans create images based on the metabolic activity of cells in the body. A small amount of radiolabeled glucose is injected into the bloodstream. The glucose is taken up and metabolized by the tissues. The PET scanner reads the signal emitted by the radiolabeled material to produce computer-generated images of your body. Since cancer cells metabolize more glucose than normal cells, they "light up" more brightly on the PET scans and can help your doctor pinpoint your disease.
PET scans may also be helpful in differentiating benign masses, such as cysts, from cancerous tumors. They may also help to identify small metastases to the liver and other surrounding organs that do not show up on CT or MRI scans. PET scans are now often done in conjunction with CT scans to provide a complete image of the body that including both molecular (PET) and anatomical (CT) visual information.
What to expect: Before the test, you will be given an injection of the radioactive substance and asked to rest for about an hour. Similar to a CT scan, you will then be asked to lie on a bed which will move slowly through a donut shaped ring. As with all scans, it is important that you do not move during the test. The entire PET scan process, from injection to completion, can take up to 3 hours.
Considerations: The PET scan is a relatively safe procedure. Most people experience no side effects due to the radiolabeled material. Allergic reactions to the radiolabeled material can occur, but are extremely rare. For most types of cancer, PET scans can only show tumors that are at least 1 cm3 in size.