Solid pancreatic lesions include mainly adenocarcinoma, neuroendocrine tumor pancreatic cystic neoplasms with solid component, solid pseudopapillary tumor, pancreatoblastoma, pancreatic lymphoma, and pancreatic metastasis. The most frequent pancreatic lesion is the adenocarcinoma, which represents between 70 to 95% of all solid pancreatic neoplasm. The diagnosis of these lesions can be a challenge and currently, there are different imaging techniques such as CT scan, EUS and MRI with high sensitivity and specificity. The most widely used technique for the initial evaluation is the CT scan with sensitivity between 76% and 92% for diagnosing pancreatic cancer. The EUS has sensitivity for the detection of pancreatic lesions around 98% and is accepted to be the most sensitive technique for detection of small pancreatic tumors (<2 cm). The MRI has very high soft-tissue contrast resolution, with accuracy in the detection and staging of adenocarcinoma of 90-100%. A multimodality approach is usually necessary in patients with clinical suspicion of pancreatic lesion. The EUS is required for local evaluation of the relation of the lesion with vessels and for tissue acquisition and the CT scan and/or MRI is usually required for the local and distance staging in case of pancreatic cancer. The purpose of this review is to provide and overview of solid pancreatic lesions and the role of the different imaging techniques in their evaluation.
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