Imaging diagnosis of pancreatic cancer: A state-of-the-art review

Table 1 Minimum technical specifications for pancreas computed tomography

Feature	Specification	Comment
Scanner type	Multi-detector row scanner
Detector type	Minimum of four detector rows
Reconstructed slice thickness	Minimum of 5 mm	Thinner slices are preferable, especially in multiplanar reconstructions (MPR)
Injector	Power injector, preferably dual-chamber	Bolus tracking desirable
Contrast injection rate	No less than 3 mL/s of contrast,	A saline flush desirable
	300 mg I/mL or a higher concentration,
	For a dose of 1.5 mL/kg of body weight
Mandatory dynamic phases	1. Early arterial phase	MPR,
	2. Pancreatic phase	Curved MPR along the pancreatic duct,
	3. Portal venous phase	Minimum intensity projections are helpful

Table 2 Minimum technical specifications for pancreas protocol magnetic resonance imaging

Feature	Specification	Comment
Scanner type	1.5-T or greater main magnetic field	Low-field magnets not suitable
Coil type	Phased-array, multichannel torso coil	Unless patient-related factors preclude the use
Gradient type	Current-generation, high-speed gradients (providing sufficient coverage of upper abdomen)
Slice thickness	5 mm or less for dynamic series,
	8 mm or less for other imaging
Breath holding and matrix	Approximately 20 s of breath hold with a minimum matrix of 128 × 256	Breath hold instructions are very important
Injector	Power injector, preferably dual-chamber	Bolus tracking/MR fluoroscopy desirable
Contrast injection rate	1.5-2 mL/s of gadolinium chelate	Preferably resulting in the vendor-recommended total dose
Minimum sequences	T1-weighted, gradient echo (3D preferable)
	T2-weighted, turbo spin echo (axial, coronal)
	MRCP (both 2D and 3D preferable)
	Post-Gd, T1-weighted gradient echo
Mandatory dynamic phases	Arterial
	Portal-venous phase
	Equilibrium phase
Dynamic timing	Arterial: 20-40 s
	Portal venous: 45-65 s
	Equilibrium: 3-5 min
	after contrast injection

MRCP: Magnetic resonance cholangiopancreatography.