Pancreatic protocol CT

Q) All are true about pancreatic protocol CT except (AIIMS 2012) 

a) > 90% unresectable lesions picked up by CT

b) Dual phase CT with cuts taken at 40 secs and 70 secs

c) Liver metastasis detected in early arterial phase


Answer is free for all 


Pancreatic protocol CT involves  imaging  at  the  pancreatic  phase (i.e.,  approximately  45  seconds  after  contrast  administration)  and  at  the  portal  venous  phase  (i.e.,  approximately 70  seconds  after  contrast  administration). It is useful for detection of adenocarcinoma of pancreas. 

Metastatic lesions are seen in  the  portal  venous  phase,  because  the  lesions  are  not  typically  well  vascularized.

  Arterial  phase images  are  principally  used  to  distinguish  metastatic  disease from  benign  vascular  lesions,  such  as  hemangiomas,  or  to  better define  the  arterial  anatomy  of  the  liver.

Non contrast phase used for 

Evaluation  of  pancreatic calcifications  and  allows  localization  of  the  precise  levels  for imaging  on  the  post contrast  study. 

Early arterial phase 

Evaluation  of  pancreatic  vasculature  without  interference  from  venous  opacification. 

Late Arterial Phase

 Distinguish pancreatic  neoplasms  from  adjacent  normal   pancreatic  tissue It  also  is useful  to  evaluate  hypervascular  liver  metastases  as  seen  in patients  with  neuroendocrine  tumors   of  the  pancreas. 

Portal Phase

Evaluate  for  hypovascular  liver  metastases 

Ref Blumgart 

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