Diagnosing and staging of periampullary adenocarcinoma

Pancreatic cancer and cancer in the surrounding area have a poor survival rate. A CT scan is usually used to detect the disease and its spread. However, it does not always accurately determine whether surgery is possible or if there are lymph node or liver metastases.This thesis explores several techniques to improve this. A newly developed computer model (Radiomics) was about as effective as a multidisciplinary team in predicting whether a pancreatic tumour could be surgically removed. MRI using an iron-based contrast agent (USPIO) showed promising results in detecting lymph node metastases, but there are still technical challenges. A retrospective study found that CT is unreliable for determining whether tumours in the duodenum can be surgically removed and if there are lymph node metastases. Finally, a new type of biopsy needle was tested, showing promising results, though further technical refinement of the needle is needed.