What is the GOLD STANDARD test for diagnosing pancreatic cancer?

The gold standard test for diagnosing pancreatic cancer is endoscopic retrograde cholangiopancreatography (ERCP). This procedure is particularly valuable because it allows for direct visualization of the ducts that carry bile and pancreatic juices. During ERCP, contrast dye is injected into these ducts, and imaging is captured, which can reveal blockages, tumors, or other abnormalities.

One of the critical advantages of ERCP is that it does not just diagnose the presence of tumors but also offers the opportunity to obtain tissue samples through biopsy if suspicious areas are identified. This capability to both visualize the pancreatic ductal anatomy and perform therapeutic interventions, such as stenting, makes ERCP indispensable in the diagnostic workflow for suspected pancreatic cancer.

While options like the CT scan, MRCP, and endoscopic ultrasound are significant diagnostic tools for pancreatic lesions, they lack the same combination of direct visualization and intervention available through ERCP. CT scans are excellent for structural imaging and assessing the extent of disease, MRCP offers non-invasive visualization of the pancreatic biliary system, and endoscopic ultrasound provides high-resolution imaging of the pancreas and surrounding tissues. However, ERCP stands out for its diagnostic and therapeutic potential in the context of pancreatic cancer, justifying its status as the gold standard.