Q) All are true about pancreatic protocol CT except (#AIIMS )
a) > 90% of un resect able lesions are picked up by CT
b) It is a dual phase CT with cuts taken at 40 secs and 70 secs
c) Liver metastasis are detected in early arterial phase
d) All are true
Ans c
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
The dedicated pancreas protocol uses 750 to 1000 mL of oral water as a negative contrast agent administered before the examination, to aid distinction of enhanced vessels from the
gastrointestinal tract
