Fig. 3

A 70-year-old man with pancreatic cancer. Axial portal venous phase image of baseline contrast-enhanced computed tomography (CECT) scan (A) shows a 5 cm-sized pancreatic cancer in the uncinate process, contacting > 180 degree with superior mesenteric artery (arrow) and causing contour irregularity of superior mesenteric vein (arrowhead). On arterial phase image of post-neoadjuvant therapy (NAT) CECT scan (B), pancreatic cancer showed decrease in size to 3 cm and ≤ 180 degree contact with superior mesenteric artery (arrow), and contour irregularity of superior mesenteric vein was resolved. CECT resectability score was 3 (indeterminate resectability) according to the three reviewers in consensus. Since there was no diffusion restriction on diffusion-weighted imaging (DWI) (C) and no fluorodexyglucose (FDG) avidity on. ¹⁸F-FDG-positron emission tomography (PET) (D) at tumor-vessel contact of post-NAT PET/MRI, and carbohydrate antigen level (CA) 19–9 was 3284 U/mL at initial diagnosis which reduced to 4 U/mL after NAT, the reviewers modified the resectability score to 4 (probably resectable) on both CT plus PET/MRI set and CT plus PET plus CA 19–9. The patient underwent Whipple’s surgery, and pathologic analysis showed no residual tumor with ypT0N0