Review ArticlesDiagnosis and Detection of Pancreatic CancerChu, Linda C. MD*; Goggins, Michael G. MBBCh, MD†; Fishman, Elliot K. MD*Author Information From *The Russell H. Morgan Department of Radiology and Radiological Science, and †The Department of Pathology, Johns Hopkins Medical Institutions, Baltimore, MD. Sources of support: Linda C. Chu and Elliot K. Fishman receive salary support from The Lustgarten Foundation. The authors have disclosed that they have no significant relationships with, or financial interest in, any commercial companies pertaining to this article. Reprints: Elliot K. Fishman, MD, JHOC 3254, 601 North Caroline St, Baltimore, MD 21287. E-mail: [email protected]. The Cancer Journal: 11/12 2017 - Volume 23 - Issue 6 - p 333-342 doi: 10.1097/PPO.0000000000000290 Buy Metrics Abstract Computed tomography is the first-line imaging modality for suspected pancreatic cancer. Magnetic resonance cholangiopancreatography is a second-line modality for suspected pancreatic cancer and is usually reserved for equivocal cases. Both computed tomography and MR are highly sensitive in the detection of pancreatic cancer, with up to 96% and 93.5% sensitivity, respectively. Computed tomography is superior to MR in the assessment of tumor resectability, with accuracy rates of up to 86.8% and 78.9%, respectively. Close attention to secondary signs of pancreatic cancer, such as pancreatic duct dilatation, abrupt pancreatic duct caliber change, and parenchymal atrophy, are critical in the diagnosis of pancreatic cancer. Emerging techniques such as radiomics and molecular imaging have the potential of identifying malignant precursors and lead to earlier disease diagnosis. The results of these promising techniques need to be validated in larger clinical studies. Copyright © 2017 Wolters Kluwer Health, Inc. All rights reserved.