Skip to main content
SpringerLink
Log in

Pancreatic Adenocarcinoma: CT and PET/CT

  • Living reference work entry
  • First Online:
Pancreatic Cancer

  • 226 Accesses

Abstract

During the last years, startling epidemiologic facts find pancreatic adenocarcinoma to be on the rise with rapidly increasing relevance for public health. Recent projections for the year 2030 predict pancreatic adenocarcinoma to range among the top three deadly cancers in the Western world (Matrisian and Berlin, Am Soc Clin Oncol Educ Book 35:e205–215, 2016; Rahib et al., Cancer Res 74:2913–2921, 2014). As a result, early detection, correct staging, and adequate peri- and posttherapeutic imaging strategies must play a very important role in present and future oncology in general and in pancreatic adenocarcinoma in particular. This will be outlined and discussed in this chapter. Early tumor detection is one of the key factors for a potential cure by surgical resection. Major advances in MDCT (multidetector computed tomography), including 2D and 3D reconstruction, are highly useful in improving staging and postsurgical care. PET-CT is particularly helpful in differentiating between malignant and benign in complex clinical problems such as discriminating between autoimmune pancreatitis and pancreatic adenocarcinoma, identifying distant metastastic disease in the pretheraupeutic staging workup, and, furthermore, discriminating between benign fibrotic tissue and tumor recurrence in the follow-up after surgical resection.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution

Institutional subscriptions

Similar content being viewed by others

References

  1. Matrisian LM, Berlin JD. The past, present, and future of pancreatic cancer clinical trials. Am Soc Clin Oncol Educ Book. 2016;35:e205–15.

    Article  PubMed  Google Scholar 

  2. Rahib L, Smith BD, Aizenberg R, Rosenzweig AB, Fleshman JM, Matrisian LM. Projecting cancer incidence and deaths to 2030: the unexpected burden of thyroid, liver, and pancreas cancers in the United States. Cancer Res. 2014;74:2913–21.

    Article  CAS  PubMed  Google Scholar 

  3. Horton KM, Fishman EK. Adenocarcinoma of the pancreas: CT imaging. Radiol Clin N Am. 2002;40:1263–72.

    Article  PubMed  Google Scholar 

  4. Richter GM, Simon C, Hoffmann V, et al. Hydrospiral CT of the pancreas in thin section technique. Radiologe. 1996;36:397–405.

    Article  CAS  PubMed  Google Scholar 

  5. Richter GM, Wunsch C, Schneider B, et al. Hydro-CT in detection and staging of pancreatic carcinoma. Radiologe. 1998;38:279–86.

    Article  CAS  PubMed  Google Scholar 

  6. Kim VM, Ahuja N. Early detection of pancreatic cancer. Chin J Cancer Res. 2015;27:321–31.

    CAS  PubMed  PubMed Central  Google Scholar 

  7. Raman SP, Horton KM, Fishman EK. Multimodality imaging of pancreatic cancer-computed tomography, magnetic resonance imaging, and positron emission tomography. Cancer J. 2012;18:511–22.

    Article  PubMed  Google Scholar 

  8. Macari M, Spieler B, Kim D, et al. Dual-source dual-energy MDCT of pancreatic adenocarcinoma: initial observations with data generated at 80 kVp and at simulated weighted-average 120 kVp. AJR Am J Roentgenol. 2010;194:W27–32.

    Article  PubMed  Google Scholar 

  9. Chu AJ, Lee JM, Lee YJ, Moon SK, Han JK, Choi BI. Dual-source, dual-energy multidetector CT for the evaluation of pancreatic tumours. Br J Radiol. 2012;85:e891–8.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  10. Patel BN, Thomas JV, Lockhart ME, Berland LL, Morgan DE. Single-source dual-energy spectral multidetector CT of pancreatic adenocarcinoma: optimization of energy level viewing significantly increases lesion contrast. Clin Radiol. 2013;68:148–54.

    Article  CAS  PubMed  Google Scholar 

  11. McNamara MM, Little MD, Alexander LF, Carroll LV, Beasley TM, Morgan DE. Multireader evaluation of lesion conspicuity in small pancreatic adenocarcinomas: complimentary value of iodine material density and low keV simulated monoenergetic images using multiphasic rapid kVp-switching dual energy CT. Abdom Imaging. 2015;40:1230–40.

    Article  PubMed  Google Scholar 

  12. Al-Hawary MM, Francis IR, Chari ST, et al. Pancreatic ductal adenocarcinoma radiology reporting template: consensus statement of the society of abdominal radiology and the American pancreatic association. Gastroenterology. 2014;146:291–304 e1.

    Article  PubMed  Google Scholar 

  13. Fogel EL, Shahda S, Sandrasegaran K, et al. A multidisciplinary approach to pancreas cancer in 2016: a review. Am J Gastroenterol. 2017;112:537–54.

    Article  PubMed  PubMed Central  Google Scholar 

  14. Crnogorac-Jurcevic T, Efthimiou E, Capelli P, et al. Gene expression profiles of pancreatic cancer and stromal desmoplasia. Oncogene. 2001;20:7437–46.

    Article  CAS  PubMed  Google Scholar 

  15. Yen TW, Aardal NP, Bronner MP, et al. Myofibroblasts are responsible for the desmoplastic reaction surrounding human pancreatic carcinomas. Surgery. 2002;131:129–34.

    Article  PubMed  Google Scholar 

  16. Cohen SJ, Alpaugh RK, Palazzo I, et al. Fibroblast activation protein and its relationship to clinical outcome in pancreatic adenocarcinoma. Pancreas. 2008;37:154–8.

    Article  CAS  PubMed  Google Scholar 

  17. Horton KM, Fishman EK. Multidetector row CT with dual-phase CT angiography in the preoperative evaluation of pancreatic cancer. Crit Rev Comput Tomogr. 2002;43:323–60.

    Article  PubMed  Google Scholar 

  18. Klauss M, Mohr A, von Tengg-Kobligk H, et al. A new invasion score for determining the resectability of pancreatic carcinomas with contrast-enhanced multidetector computed tomography. Pancreatology. 2008;8:204–10.

    Article  CAS  PubMed  Google Scholar 

  19. Kim SI, Shin JY, Park JS, et al. Vascular enhancement pattern of mass in computed tomography may predict chemo-responsiveness in advanced pancreatic cancer. Pancreatology. 2017;17:103–8.

    Article  PubMed  Google Scholar 

  20. Neuzillet C, Tijeras-Raballand A, Cros J, Faivre S, Hammel P, Raymond E. Stromal expression of SPARC in pancreatic adenocarcinoma. Cancer Metastasis Rev. 2013;32:585–602.

    Article  CAS  PubMed  Google Scholar 

  21. Patsouras D, Papaxoinis K, Kostakis A, Safioleas MC, Lazaris AC, Nicolopoulou-Stamati P. Fibroblast activation protein and its prognostic significance in correlation with vascular endothelial growth factor in pancreatic adenocarcinoma. Mol Med Rep. 2015;11:4585–90.

    Article  CAS  PubMed  Google Scholar 

  22. Kim JH, Park SH, Yu ES, et al. Visually isoattenuating pancreatic adenocarcinoma at dynamic-enhanced CT: frequency, clinical and pathologic characteristics, and diagnosis at imaging examinations. Radiology. 2010;257:87–96.

    Article  PubMed  Google Scholar 

  23. Prokesch RW, Schima W, Chow LC, Jeffrey RB. Multidetector CT of pancreatic adenocarcinoma: diagnostic advances and therapeutic relevance. Eur Radiol. 2003;13:2147–54.

    Article  PubMed  Google Scholar 

  24. Fishman EK, Ney DR, Heath DG, Corl FM, Horton KM, Johnson PT. Volume rendering versus maximum intensity projection in CT angiography: what works best, when, and why. Radiographics. 2006;26:905–22.

    Article  PubMed  Google Scholar 

  25. Crosara S, D'Onofrio M, De Robertis R, et al. Autoimmune pancreatitis: multimodality non-invasive imaging diagnosis. World J Gastroenterol. 2014;20:16881–90.

    Article  PubMed  PubMed Central  Google Scholar 

  26. Rotzinger R, Blaker H, Bahra M, Denecke T, Grieser C. CT and MRI findings of autoimmune polymorph bifocal pancreatitis mimicking pancreatic adenocarcinoma: a case report and review of the literature. J Investig Med High Impact Case Rep. 2015;3:2324709615576988.

    PubMed  PubMed Central  Google Scholar 

  27. Buchs NC, Buhler L, Bucher P, et al. Value of contrast-enhanced 18F-fluorodeoxyglucose positron emission tomography/computed tomography in detection and presurgical assessment of pancreatic cancer: a prospective study. J Gastroenterol Hepatol. 2011;26:657–62.

    Article  PubMed  Google Scholar 

  28. Ozaki Y, Oguchi K, Hamano H, et al. Differentiation of autoimmune pancreatitis from suspected pancreatic cancer by fluorine-18 fluorodeoxyglucose positron emission tomography. J Gastroenterol. 2008;43:144–51.

    Article  CAS  PubMed  Google Scholar 

  29. Bockhorn M, Uzunoglu FG, Adham M, et al. Borderline resectable pancreatic cancer: a consensus statement by the International Study Group of Pancreatic Surgery (ISGPS). Surgery. 2014;155:977–88.

    Article  PubMed  Google Scholar 

  30. Brierley JD, Gospodarowicz MK, Wittekind C, editors. TNM classification of malignant tumours. 8th ed. Chichester: Wiley; 2016.

    Google Scholar 

  31. Yeo CJ, Cameron JL, Lillemoe KD, et al. Pancreaticoduodenectomy for cancer of the head of the pancreas. 201 patients. Ann Surg. 1995;221:721–31; discussion 31-3.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  32. Shimada K, Sakamoto Y, Sano T, Kosuge T. Prognostic factors after distal pancreatectomy with extended lymphadenectomy for invasive pancreatic adenocarcinoma of the body and tail. Surgery. 2006;139:288–95.

    Article  PubMed  Google Scholar 

  33. Franko J, Hugec V, Lopes TL, Goldman CD. Survival among pancreaticoduodenectomy patients treated for pancreatic head cancer <1 or 2 cm. Ann Surg Oncol. 2013;20:357–61.

    Article  PubMed  Google Scholar 

  34. Benassai G, Mastrorilli M, Quarto G, et al. Factors influencing survival after resection for ductal adenocarcinoma of the head of the pancreas. J Surg Oncol. 2000;73:212–8.

    Article  CAS  PubMed  Google Scholar 

  35. Benassai G, Mastrorilli M, Quarto G, Cappiello A, Giani U, Mosella G. Survival after pancreaticoduodenectomy for ductal adenocarcinoma of the head of the pancreas. Chir Ital. 2000;52:263–70.

    CAS  PubMed  Google Scholar 

  36. Winter JM, Cameron JL, Campbell KA, et al. 1423 pancreaticoduodenectomies for pancreatic cancer: a single-institution experience. J Gastrointest Surg. 2006;10:1199–210; discussion 210-1.

    Article  PubMed  Google Scholar 

  37. Kurata M, Honda G, Murakami Y, et al. Retrospective study of the correlation between pathological tumor size and survival after curative resection of T3 pancreatic adenocarcinoma: proposal for reclassification of the tumor extending beyond the pancreas based on tumor size. World J Surg. 2017;41:2867.

    Article  PubMed  PubMed Central  Google Scholar 

  38. Crippa S, Partelli S, Falconi M. Pancreatic ductal adenocarcinoma: a new TNM staging system is needed! Ann Surg. 2016;266:e108.

    Article  Google Scholar 

  39. Marinelli T, Filippone A, Tavano F, et al. A tumour score with multidetector spiral CT for venous infiltration in pancreatic cancer: influence on borderline resectable. Radiol Med. 2014;119:334–42.

    PubMed  Google Scholar 

  40. Pietryga JA, Morgan DE. Imaging preoperatively for pancreatic adenocarcinoma. J Gastrointest Oncol. 2015;6:343–57.

    PubMed  PubMed Central  Google Scholar 

  41. Balci NC, Perman WH, Saglam S, Akisik F, Fattahi R, Bilgin M. Diffusion-weighted magnetic resonance imaging of the pancreas. Top Magn Reson Imaging. 2009;20:43–7.

    Article  PubMed  Google Scholar 

  42. Holzapfel K, Reiser-Erkan C, Fingerle AA, et al. Comparison of diffusion-weighted MR imaging and multidetector-row CT in the detection of liver metastases in patients operated for pancreatic cancer. Abdom Imaging. 2011;36:179–84.

    Article  PubMed  Google Scholar 

  43. Tang S, Huang G, Liu J, et al. Usefulness of 18F-FDG PET, combined FDG-PET/CT and EUS in diagnosing primary pancreatic carcinoma: a meta-analysis. Eur J Radiol. 2011;78:142–50.

    Article  PubMed  Google Scholar 

  44. Pakzad F, Groves AM, Ell PJ. The role of positron emission tomography in the management of pancreatic cancer. Semin Nucl Med. 2006;36:248–56.

    Article  PubMed  Google Scholar 

  45. Kauhanen SP, Komar G, Seppanen MP, et al. A prospective diagnostic accuracy study of 18F-fluorodeoxyglucose positron emission tomography/computed tomography, multidetector row computed tomography, and magnetic resonance imaging in primary diagnosis and staging of pancreatic cancer. Ann Surg. 2009;250:957–63.

    Article  PubMed  Google Scholar 

  46. Grassetto G, Rubello D. Role of FDG-PET/CT in diagnosis, staging, response to treatment, and prognosis of pancreatic cancer. Am J Clin Oncol. 2011;34:111–4.

    PubMed  Google Scholar 

  47. Tempero MA, Arnoletti JP, Behrman S, et al. Pancreatic adenocarcinoma. J Natl Compr Cancer Netw. 2010;8:972–1017.

    Article  CAS  Google Scholar 

  48. Tempero MA, Arnoletti JP, Behrman SW, et al. Pancreatic adenocarcinoma, version 2.2012: featured updates to the NCCN guidelines. J Natl Compr Cancer Netw. 2012;10:703–13.

    Article  CAS  Google Scholar 

  49. Conlon KC, Klimstra DS, Brennan MF. Long-term survival after curative resection for pancreatic ductal adenocarcinoma. Clinicopathologic analysis of 5-year survivors. Ann Surg. 1996;223:273–9.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  50. Wolfgang CL, Corl F, Johnson PT, et al. Pancreatic surgery for the radiologist, 2011: an illustrated review of classic and newer surgical techniques for pancreatic tumor resection. AJR Am J Roentgenol. 2011;197:1343–50.

    Article  PubMed  Google Scholar 

  51. Feilhauer K, Hennig R, Lenz S, Koninger J. Pancreatic resection in the elderly: is the risk justified? Chirurg. 2015;86:670–5.

    Article  CAS  PubMed  Google Scholar 

  52. Bassi C, Dervenis C, Butturini G, et al. Postoperative pancreatic fistula: an international study group (ISGPF) definition. Surgery. 2005;138:8–13.

    Article  PubMed  Google Scholar 

  53. Shrikhande SV, Sivasanker M, Vollmer CM, et al. Pancreatic anastomosis after pancreatoduodenectomy: a position statement by the International Study Group of Pancreatic Surgery (ISGPS). Surgery. 2017;161:1221–34.

    Article  PubMed  Google Scholar 

  54. Besselink MG, van Rijssen LB, Bassi C, et al. Definition and classification of chyle leak after pancreatic operation: a consensus statement by the International Study Group on Pancreatic Surgery. Surgery. 2017;161:365–72.

    Article  PubMed  Google Scholar 

  55. Bassi C, Marchegiani G, Dervenis C, et al. The 2016 update of the International Study Group (ISGPS) definition and grading of postoperative pancreatic fistula: 11 years after. Surgery. 2017;161:584–91.

    Article  PubMed  Google Scholar 

  56. Wente MN, Veit JA, Bassi C, et al. Postpancreatectomy hemorrhage (PPH): an International Study Group of Pancreatic Surgery (ISGPS) definition. Surgery. 2007;142:20–5.

    Article  PubMed  Google Scholar 

  57. Wente MN, Bassi C, Dervenis C, et al. Delayed gastric emptying (DGE) after pancreatic surgery: a suggested definition by the International Study Group of Pancreatic Surgery (ISGPS). Surgery. 2007;142:761–8.

    Article  PubMed  Google Scholar 

  58. Raman SP, Horton KM, Cameron JL, Fishman EK. CT after pancreaticoduodenectomy: spectrum of normal findings and complications. AJR Am J Roentgenol. 2013;201:2–13.

    Article  PubMed  Google Scholar 

  59. Burkhart RA, Relles D, Pineda DM, et al. Defining treatment and outcomes of hepaticojejunostomy failure following pancreaticoduodenectomy. J Gastrointest Surg. 2013;17:451–60.

    Article  PubMed  Google Scholar 

  60. Antolovic D, Koch M, Galindo L, et al. Hepaticojejunostomy–analysis of risk factors for postoperative bile leaks and surgical complications. J Gastrointest Surg. 2007;11:555–61.

    Article  PubMed  Google Scholar 

  61. Suzuki Y, Fujino Y, Tanioka Y, et al. Factors influencing hepaticojejunostomy leak following pancreaticoduodenal resection; importance of anastomotic leak test. Hepato-Gastroenterology. 2003;50:254–7.

    PubMed  Google Scholar 

  62. Koch M, Garden OJ, Padbury R, et al. Bile leakage after hepatobiliary and pancreatic surgery: a definition and grading of severity by the International Study Group of Liver Surgery. Surgery. 2011;149:680–8.

    Article  PubMed  Google Scholar 

  63. Stampfl U, Hackert T, Radeleff B, et al. Percutaneous management of postoperative bile leaks after upper gastrointestinal surgery. Cardiovasc Intervent Radiol. 2011;34:808–15.

    Article  CAS  PubMed  Google Scholar 

  64. Machado NO. Pancreatic fistula after pancreatectomy: definitions, risk factors, preventive measures, and management-review. Int J Surg Oncol. 2012;2012:602478.

    PubMed  Google Scholar 

  65. Lai EC, Lau SH, Lau WY. Measures to prevent pancreatic fistula after pancreatoduodenectomy: a comprehensive review. Arch Surg. 2009;144:1074–80.

    Article  PubMed  Google Scholar 

  66. Winter JM, Cameron JL, Yeo CJ, Lillemoe KD, Campbell KA, Schulick RD. Duodenojejunostomy leaks after pancreaticoduodenectomy. J Gastrointest Surg. 2008;12:263–9.

    Article  PubMed  Google Scholar 

  67. Schulick RD. Complications after pancreaticoduodenectomy: intraabdominal abscess. J Hepato-Biliary-Pancreat Surg. 2008;15:252–6.

    Article  Google Scholar 

  68. Puppala S, Patel J, McPherson S, Nicholson A, Kessel D. Hemorrhagic complications after Whipple surgery: imaging and radiologic intervention. AJR Am J Roentgenol. 2011;196:192–7.

    Article  PubMed  Google Scholar 

  69. Ansari D, Tingstedt B, Lindell G, Keussen I, Ansari D, Andersson R. Hemorrhage after major pancreatic resection: incidence, risk factors, management, and outcome. Scand J Surg. 2017;106:47–53.

    Article  CAS  PubMed  Google Scholar 

  70. Zhang J, Zhu X, Chen H, et al. Management of delayed post-pancreaticoduodenectomy arterial bleeding: interventional radiological treatment first. Pancreatology. 2011;11:455–63.

    Article  PubMed  Google Scholar 

  71. Limongelli P, Khorsandi SE, Pai M, et al. Management of delayed postoperative hemorrhage after pancreaticoduodenectomy: a meta-analysis. Arch Surg. 2008;143:1001–7; discussion 7.

    Article  PubMed  Google Scholar 

  72. Raty S, Sand J, Lantto E, Nordback I. Postoperative acute pancreatitis as a major determinant of postoperative delayed gastric emptying after pancreaticoduodenectomy. J Gastrointest Surg. 2006;10:1131–9.

    Article  PubMed  Google Scholar 

  73. Strobel O, Buchler MW. Pancreatic ductal adenocarcinoma: a new TNM staging system is needed! Ann Surg. 2016;266:e109.

    Article  Google Scholar 

  74. Basturk O, Hong SM, Wood LD, et al. A revised classification system and recommendations from the Baltimore consensus meeting for neoplastic precursor lesions in the pancreas. Am J Surg Pathol. 2015;39:1730–41.

    Article  PubMed  PubMed Central  Google Scholar 

  75. Glebova NO, Hicks CW, Piazza KM, et al. Technical risk factors for portal vein reconstruction thrombosis in pancreatic resection. J Vasc Surg. 2015;62:424–33.

    Article  PubMed  Google Scholar 

  76. Glebova NO, Hicks CW, Tosoian JJ, et al. Outcomes of arterial resection during pancreatectomy for tumor. J Vasc Surg. 2016;63:722–9 e1.

    Article  PubMed  Google Scholar 

  77. Miura F, Asano T, Amano H, et al. Eleven cases of postoperative hepatic infarction following pancreato-biliary surgery. J Gastrointest Surg. 2010;14:352–8.

    Article  PubMed  Google Scholar 

  78. Kunstman JW, Fonseca AL, Ciarleglio MM, Cong X, Hochberg A, Salem RR. Comprehensive analysis of variables affecting delayed gastric emptying following pancreaticoduodenectomy. J Gastrointest Surg. 2012;16:1354–61.

    Article  PubMed  Google Scholar 

  79. Roeder F, Timke C, Uhl M, et al. Aggressive local treatment containing intraoperative radiation therapy (IORT) for patients with isolated local recurrences of pancreatic cancer: a retrospective analysis. BMC Cancer. 2012;12:295.

    Article  PubMed  PubMed Central  Google Scholar 

  80. Esposito I, Kleeff J, Bergmann F, et al. Most pancreatic cancer resections are R1 resections. Ann Surg Oncol. 2008;15:1651–60.

    Article  PubMed  Google Scholar 

  81. Esposito I, Konukiewitz B, Schlitter AM, Kloppel G. Pathology of pancreatic ductal adenocarcinoma: facts, challenges and future developments. World J Gastroenterol. 2014;20:13833–41.

    Article  PubMed  PubMed Central  Google Scholar 

  82. Neoptolemos JP, Stocken DD, Dunn JA, et al. Influence of resection margins on survival for patients with pancreatic cancer treated by adjuvant chemoradiation and/or chemotherapy in the ESPAC-1 randomized controlled trial. Ann Surg. 2001;234:758–68.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  83. Wilkowski R, Thoma M, Bruns C, Duhmke E, Heinemann V. Combined chemoradiotherapy for isolated local recurrence after primary resection of pancreatic cancer. JOP. 2006;7:34–40.

    PubMed  Google Scholar 

  84. Heye T, Zausig N, Klauss M, et al. CT diagnosis of recurrence after pancreatic cancer: is there a pattern? World J Gastroenterol. 2011;17:1126–34.

    Article  PubMed  PubMed Central  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Clinic for Diagnostic and Interventional Radiology, Klinikum Stuttgart, Stuttgart, Germany

    Götz M. Richter

Authors
  1. Götz M. Richter
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Götz M. Richter .

Editor information

Editors and Affiliations

  1. Department of General Surgery, University Hospital Heidelberg Department of General Surgery, Heidelberg, Germany

    John Neoptolemos

  2. Rochester, Minnesota, USA

    Raul Urrutia

  3. Dept. Gastrointestinal Medical Onco, Duke University Medical Center Dept. Gastrointestinal Medical Onco, Durham, North Carolina, USA

    James Abbruzzese

  4. Heidelberg, Germany

    Markus W. Büchler

Rights and permissions

Reprints and permissions

Copyright information

© 2018 Springer Science+Business Media LLC

About this entry

Check for updates. Verify currency and authenticity via CrossMark

Cite this entry

Richter, G.M. (2018). Pancreatic Adenocarcinoma: CT and PET/CT. In: Neoptolemos, J., Urrutia, R., Abbruzzese, J., Büchler, M. (eds) Pancreatic Cancer. Springer, New York, NY. https://doi.org/10.1007/978-1-4939-6631-8_90-1

Download citation

  • DOI: https://doi.org/10.1007/978-1-4939-6631-8_90-1

  • Received:

  • Accepted:

  • Published:

  • Publisher Name: Springer, New York, NY

  • Print ISBN: 978-1-4939-6631-8

  • Online ISBN: 978-1-4939-6631-8

  • eBook Packages: Springer Reference Biomedicine and Life SciencesReference Module Biomedical and Life Sciences

Publish with us

Policies and ethics

Search

Navigation