Pancreatic adenocarcinoma in a 46-year old woman with jaundice. (a, b) Axial (a) and coronal (b) contrast-enhanced multidetector CT images show indeterminate findings in the pancreatic head (arrow) and dilatation of the main pancreatic duct (arrowhead in b). A plastic stent is also seen in the common bile duct. (c, d) Axial (c) and coronal (d) fused PET/CT images show a focal area of slightly increased FDG activity in the pancreatic head (arrow). Initial endoscopic US–guided fine-needle aspiration findings were nondiagnostic; however, analysis of subsequent percutaneous biopsy specimens, obtained by directing sampling toward the location highlighted at PET/CT, confirmed the diagnosis of adenocarcinoma.