The edition · Radiology
Pancreatic cancer staging: MRI found liver metastases CT missed, while CT judged resectability more reliably
A meta-analysis of 40 head-to-head studies supports adding liver MRI before curative surgery, fewer than 1 in 10 imaging follow-ups were completed for incarcerated patients, and an in-record chat function halved calls to the duty radiologist.
The edition in brief
A European Radiology meta-analysis of 40 direct comparative studies (1 October 2026) found CT, MRI and endoscopic ultrasound similar for detecting pancreatic ductal adenocarcinoma, but MRI more sensitive for liver metastases (0.89 vs 0.60) and CT more specific for resectability (0.88 vs 0.63) and better for vascular invasion; endoscopic ultrasound was most sensitive for nodes. A single-centre US review found only 8.6% of follow-up recommendations for incarcerated emergency and inpatient patients were completed as outpatients on time. A tertiary department's electronic-record chat channel, with education, cut daily calls to the duty radiologist from 181 to 82 without slowing protocolling (rate ratio for all contacts 0.56). In NELSON screening data, screen-detected adenocarcinomas were smaller, slower-growing and more often upper-lobe or pleural-based than other lung cancers. Pearl: every follow-up recommendation needs a modality, an interval and an owner.
Fewer than 1 in 10 imaging follow-ups for incarcerated patients were completed on time
Do not rely on the report alone for follow-up in incarcerated patients; use a tracked closed-loop pathway.
An in-record chat channel halved telephone calls to the duty radiologist
Consider an in-record chat channel with referrer education to cut interruptions to the duty radiologist.
Screen-detected adenocarcinomas were smaller, slower and more often upper-lobe or pleural-based
In lung screening, slow growth and pleural contact do not exclude adenocarcinoma; keep to validated nodule management.
A follow-up recommendation needs a modality, an interval and an owner
Write follow-up recommendations with a named test, a clear interval and a route to the person who will act.
Before pancreatic cancer surgery, MRI was more sensitive than CT for liver metastases
Consider adding liver MRI to pancreatic-protocol CT before a potentially curative pancreatic cancer resection.
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