@yellie You raise a good question about use of CT vs MRI regarding tumor detection and surveillance and it is a common point of confusion for the lay person.. I have spoken to several radiologists for their response.

CT is usually the first test because it’s fast, widely available (especially in the ER), and excellent for seeing things like bile duct blockage, liver spread, lymph nodes, and surgical anatomy. It’s also much less expensive and easier for very ill patients to tolerate. So when time is of the essence because the patient is experiencing acute pain and discomfort from symptoms, the CT is specified in diagnostic protocols.

MRI/MRCP is more sensitive for small pancreatic and bile duct tumors, but it takes longer, is more expensive, and isn’t always available urgently—so it’s often used after CT when more detail is needed.

Even when a tumor isn’t clearly visible on CT, CT is still very useful for monitoring spread, treatment response, and overall anatomy, which is why it remains the standard follow-up scan.

If a patient is stable and there’s no urgency, they absolutely can ask their team whether MRI/MRCP would add useful information.

@yellie Immediately get to a center that specializes in adenocarcinoma and have it removed. He is very lucky that it has been caught so soon. Dr. Evens at Froedtert in Wi is the best surgeon in US for pancreas cancer.