Imaging tests for pancreatic cancer
CT, MRI and MRCP, ultrasound, endoscopic ultrasound and PET answer different questions in pancreatic cancer. What each scan can show, how to prepare, and what happens with your results.
Imaging tests create pictures of structures inside the body. They can help your care team investigate symptoms, assess the pancreas, look for signs of cancer spread, and plan treatment.
You may need more than one type of scan because different tests answer different questions. Your team will explain which tests are appropriate for you.
This guide mainly concerns suspected or diagnosed pancreatic ductal adenocarcinoma, the most common type of pancreatic cancer. Imaging for pancreatic neuroendocrine tumours may involve different tests.
CT · MRI and MRCP · Ultrasound and EUS · PET · Preparing · Results
Why might I need imaging?
Before any machine is involved, it helps to know what question your team is trying to answer. Imaging may be ordered to investigate:
- Is there an abnormality in the pancreas?
- Where is it, and how large is it?
- Are nearby blood vessels or other structures involved?
- Are there signs of spread elsewhere in the body?
- Could surgery be possible?
- Is further investigation needed?
A scan does not always provide a definite diagnosis or answer every question. Sometimes the result points to the next test rather than a conclusion.
| Test | What it may help assess | Good to know |
|---|---|---|
| CT scan | The pancreatic tumour, nearby blood vessels, and possible spread | Often an early imaging test when pancreatic cancer is suspected |
| MRI | Detailed views of tissues, including questions about the pancreas or liver | Uses magnetic fields and radio waves, not x-rays |
| MRCP | The pancreatic and bile ducts | A particular MRI technique — not an endoscopic procedure |
| Abdominal ultrasound | Possible causes of symptoms, including problems around the pancreas and nearby organs | Different from endoscopic ultrasound |
| Endoscopic ultrasound (EUS) | A closer view of the pancreas; may also guide tissue sampling | Requires an endoscopic procedure |
| PET, usually combined with CT | Additional information about tissue activity and possible spread, in selected circumstances | Not a scan everyone needs |
CT scans and pancreatic-protocol CT
A CT scan uses x-rays and computer processing to produce detailed cross-sectional images of the body. For pancreatic cancer, CT can help assess the size of a tumour, whether it may have spread, and whether surgical removal may be possible.
You may hear the term "pancreatic-protocol CT." This describes a scan planned specifically to assess the pancreas: images are taken at carefully timed points so the pancreas and nearby blood vessels show in more detail. If you have already had a CT scan, ask whether it provides the information your specialist needs — an existing scan may be adequate, or your team may need a different study. A second scan is not automatically necessary.
Some CT scans use a contrast agent, often injected through a vein, to make structures easier to see. The imaging service will explain whether contrast is planned and what information it needs from you beforehand.
MRI and MRCP
MRI uses a strong magnetic field and radio waves to create detailed images. It may be used to clarify findings from another scan, or to examine areas such as the liver more closely. MRI is not automatically better than CT — the choice depends on the question your team is asking.
MRCP is a type of MRI that provides detailed pictures of the bile ducts and the pancreatic duct. Despite the similar name to endoscopic procedures, MRCP does not involve passing an endoscope through the mouth.
Before an MRI: tell the MRI service about implanted devices, metal in your body, previous contrast reactions, kidney problems, or concerns about enclosed spaces. The service will assess what precautions or adjustments are needed.
Ultrasound and endoscopic ultrasound
Abdominal ultrasound
In an abdominal ultrasound, a probe is moved over the skin of the abdomen to create images using sound waves. It may be part of the investigation when the cause of symptoms is not yet clear, including problems around the pancreas and nearby organs.
Endoscopic ultrasound (EUS)
Endoscopic ultrasound is a different experience. An ultrasound probe is passed into the digestive tract on an endoscope, which gives a closer view of the pancreas. Tissue sampling (a biopsy) may be performed during the same procedure. Preparation, sedation, and biopsy details belong with the procedure itself — see the guides below rather than general information here.
Learn about endoscopic procedures · Understand pancreatic biopsy
PET scans
PET scans use a small amount of a radioactive tracer to show patterns of activity in tissues. PET is often combined with CT in a single appointment. A PET-based scan may be used in selected circumstances to provide additional information about possible spread. It is not required for every person being assessed for pancreatic cancer, and not having one does not mean an assessment is incomplete.
Before your appointment
Preparation varies by test and by imaging service. Rather than general rules, use this checklist of questions when your appointment is booked:
- Do I need to avoid eating or drinking beforehand?
- Will contrast be used?
- Do you need recent blood tests?
- Do I need to discuss any of my medicines beforehand?
- What should I tell you about allergies or previous reactions?
- If sedation is involved, do I need someone to take me home?
- How can I request accessibility, language, or anxiety-related support?
Follow the instructions from your imaging service. Do not stop medicines or change your diabetes treatment based on general website advice.
What happens after the scan?
Waiting for results is often the hardest part. These questions can help you prepare for the conversation:
- Who will review the report?
- When, and how, will someone explain it to me?
- Does the scan answer the question it was ordered for?
- Is another test, or a biopsy, needed?
- Does it change the surgical or treatment assessment?
Imaging and tissue testing provide different information. A biopsy examines cells or tissue; imaging shows structures and patterns inside the body. Whether tissue sampling is needed before the next step depends on your circumstances — your team will explain their reasoning.
Is this the same as screening?
No. Imaging ordered to investigate symptoms, or to assess known cancer, is different from screening someone who has no symptoms. Routine pancreatic cancer screening is not recommended for people at average risk. Selected people at high inherited risk may be assessed for specialist surveillance — our guide to genetic testing and inherited risk explains who may qualify.
Related guides
- Endoscopic procedures for pancreatic cancer
- Biopsy for pancreatic cancer
- Blood testing for pancreatic cancer
- Stages of pancreatic cancer
- Surgery for pancreatic cancer
Sources
- Canadian Cancer Society — Diagnosis of pancreatic cancer
- Canadian Cancer Society — Computed tomography (CT) scan
- Canadian Cancer Society — Magnetic resonance imaging (MRI)
- U.S. National Cancer Institute — Pancreatic cancer screening
Last reviewed: October 24, 2026
This guide provides general information only and is not medical advice. Your care team's instructions and explanations take priority for your situation.