Best investigation is to assess the resectability of Cancer Pancreas?
**Core Concept**
The assessment of resectability in pancreatic cancer involves evaluating the extent of tumor involvement with surrounding structures and determining the feasibility of surgical resection. This requires a combination of imaging modalities to accurately stage the tumor and assess the presence of metastatic disease or local invasion.
**Why the Correct Answer is Right**
The correct answer is **MRI with IV contrast**. MRI provides high-resolution images of the pancreas and surrounding structures, allowing for detailed evaluation of tumor size, location, and relationship to vital structures such as the superior mesenteric artery and portal vein. IV contrast enhancement further aids in identifying vascular invasion and assessing the presence of metastatic disease.
**Why Each Wrong Option is Incorrect**
**Option A:** CT scan with IV contrast is often used as an initial imaging modality for pancreatic cancer, but it may not provide the same level of detail as MRI in assessing resectability.
**Option B:** Endoscopic ultrasound (EUS) is useful for assessing the local extent of disease and guiding fine-needle aspiration for tissue diagnosis, but it is not the best modality for assessing resectability.
**Option C:** Positron emission tomography (PET) scan is useful for detecting metastatic disease, but it is not the best modality for assessing the local extent of disease or resectability.
**Clinical Pearl / High-Yield Fact**
In the assessment of pancreatic cancer, the presence of a hypervascular tumor blush on imaging studies suggests vascular invasion and may indicate a poor prognosis.
**Correct Answer:** C. MRI with IV contrast is the best investigation to assess the resectability of pancreatic cancer.